Toledo firefighter Joe Clark and Battalion Chief Chris Davis comfort Karis Thomas, 2, who was a passenger in a van that was involved in a May 31 traffic accident in West Toledo.
On April 23, 2005, Quelia Stewart drove through a traffic signal at Hawley Street and Nebraska Avenue that was the same color as her red 1994 Chevy Corsica.
Her car collided with a van.
A Toledo Fire Department crew of four firefighters/emergency medical technicians responded. They checked on Ms. Stewart's injured ankle and the condition of the other driver, who was fine, and left less than three minutes later.
The fire department's billing contractor sent Ms. Stewart's insurance company a "motor vehicle accident response" bill for $635.
Ms. Stewart, 26, a Toledo resident, said she did not know her insurance company, Safe Auto, had paid the bill and was surprised that the fire department would charge for the service in the first place.
"It's their civic duty to make sure everybody's OK," she said.
Toledo's "motor vehicle accident response fee," established in late 2004, has become controversial as Toledo residents or their insurance agents have been presented with unexpected bills ranging higher than $2,500 for a service many thought was paid for by taxes.
As a result, a proposal from the police department for a similar fee has been left untouched in committee for months, and City Council President Rob Ludeman has promised hearings on the fire department fee before acting on a fee for the police department.
A Blade review of the accident response fee program shows that the city has collected $231,704 from insurance companies and drivers whom police cited as responsible for injury accidents.
"What if they had been there for half an hour and I was seriously injured? Would they have charged me two grand?" Ms. Stewart wondered.
The answer: Probably.
The services provided Ms. Stewart included: "administered care, assisted in patient care, determined if injuries, directed traffic, established a safety zone." Those same services are listed on all of the bills sent on the city's behalf by Cost Recovery Corp., a Dayton-area firm that gets 10 percent of every bill paid.
The amount billed is based on the number of EMTs responding to an accident and the time spent there. Of the 2,998 accident reports sent to Cost Recovery since early 2005, 563 involved total time on scene of less than 10 minutes; 1,980 took between 10 and 30 minutes; and 455 responses lasted longer than 30 minutes.
The fees are permitted under an ordinance Toledo City Council passed in December, 2004, and were put in place by the fire department on Jan. 1, 2005.
At the time the fee was approved, city government was reeling from a budget crisis and then-Mayor Jack Ford was threatening police and fire layoffs. Since then, the city's fiscal situation has improved somewhat - at least enough that layoff talk has stopped, and the city has granted city employees pay raises of 6.5 percent over three years.
Yet the trend of Toledo and other cities nationwide toward billing insurance companies to subsidize their police and fire operations hasn't stopped. Instead, it has increased. That has raised alarms among insurers, who contend their policies only cover actual medical services.
Fire Chief Mike Bell said he believes the fees are justified, and that it's normal for people to feel the fees are out of proportion to the work performed.
"I believe we're in the standard of what's supposed to be charged. We're just going with the going rate of what's charged for that particular duty," Chief Bell said.
"The insurance companies are trying to say this is not an acceptable charge against your insurance. We're saying it is an acceptable charge. There is funding you pay for in your premium for this particular service," Chief Bell said.
Toledo firefighters make more than 50,000 runs a year to medical emergencies, injury accidents, and fires, the chief said. That's more than double the number 20 years ago, but without a proportional rise in funding.
If the motor vehicle accident fee is eliminated, Chief Bell said the department would either have to find a way to make up the lost money or cut services.
The easy insurance money has prompted the Toledo Police Department to begin eyeing the motor vehicle accident response fee as a way to subsidize its expenses.
Former police Chief Jack Smith submitted an ordinance to begin collecting such fees in April, but the ordinance has remained in council's committee of the whole. His successor, Chief Mike Navarre, said he is studying the concept before asking council to consider passing the ordinance. He said he plans to survey other cities that have the fee.
The accident response fee program is activated when a fire department engine is dispatched to an injury accident. A report of the incident is forwarded to Cost Recovery Corp. for collection.
Using its computers, Cost Recovery accesses Toledo police accident reports online to identify the driver cited in the accident and the name of his or her insurance company. Cost Recovery then sends a bill to that insurance company. If no citation was issued, no bill goes out. Under a rule added last year, bills are not sent out for accidents when firefighter time on scene is less than 3 minutes.
If the insurance company refuses to pay, Cost Recovery begins sending the bills to the person who was charged in the accident.
Sometimes when the person doesn't pay, they get a scolding letter signed "Toledo Fire Dept., Billing Department."
Since the fees went into effect last year, Cost Recovery has collected more than $23,000.
Regina Moore, a spokesman for Cost Recovery, said the bills are paid by insurance companies about half the time and by individuals about half the time.
During 2005, Cost Recovery Corp. typically charged about $635 for a crew of four EMTs and up to $2,045 for three engines and 12 EMTs.
Still, only a fraction of potential cases are being collected. Of 2,998 accident reports supplied to Cost Recovery dating to January, 2005, the company has collected on only 286 of them - in part because insurers frequently simply refuse to pay.
The insurance industry has increasingly raised complaints about the program, which it views as a money-making opportunity that was not contemplated in the way insurance policies are written.
Daniel Kelso, president of the Ohio Insurance Institute, an industry lobbying group, said insurance policies pay for legitimate medical expenses.
But he said his members are complaining that many of the charges are "bogus," or not substantiated.
"If there's a fender-bender and they send four EMTs, do they need four EMTs? Are we just trying to make money?" Mr. Kelso asked.
He said cities are being sold on the program by the expectations that insurance companies will simply pay the fees.
Chief Bell denied that the fire department has an incentive to exaggerate its service at injury accidents.
"The firefighters' whole function when they get on the scene is to give the best care for the patient. They're not thinking about how to make money for the city," he said.
Examples abound of charges that would make the Pentagon's $600 toilet seats look cheap:
•Cost Recovery Corp. charged $1,579 to respond to a minor accident at Detroit and Glendale avenues on Aug. 11, 2005. The incident occurred directly in front of the city's fire station.
Motorist Marquita Davis, 41, the victim, said the service rendered by the firefighters was fine, but minimal.
She said they walked out of the fire station to check on her after her car was rear-ended at the stop light.
According to Cost Recovery's bill, the fire department sent a ladder truck, a fire engine, and eight emergency medical technicians, and they stayed on the scene more than 17 minutes.
"They walked out [of the fire hall] because it was right in front of there. They put a brace on me and put me on a wooden board," Ms. Davis said.
•In another case in front of a fire station, Georgia Bieber ran a red light at Franklin Avenue and Bancroft Street on April 14, 2005.
She was taken to the hospital by a private ambulance to check out a bump on her head and was cited for the accident. A year later, she received a bill from Cost Recovery for $1,434.
"They administered no medical treatment at all. The firemen did assist getting me out of the car, like a gentleman would help a lady out of a car," she said.
Mrs. Bieber, 54, a Maumee resident who works in Toledo and pays a share of Toledo's 2.25 percent wage tax, said she challenged the bill through phone calls and got it reduced to $27.
Chief Bell agreed the fee was high, and said the fact that she was able to get it lowered proves that complaints are treated seriously.
Ms. Moore said, "Each situation is different.
"We provide a copy of the ordinance that shows first of all that the city has passed an ordinance allowing for charging of the fee and on the invoice we provide the information that's necessary to describe the incident. We have a few that will ask for more detail," Ms. Moore said.
Some policyholders simply pay the bill.
Marcia Selleck, 42, of Oregon lost control of her car going around a corner at Front and Oak streets and struck a utility pole on March 9, 2005.
She shattered an ankle. City records state that a crew of three firefighters spent 12 minutes and 18 seconds responding to her accident.
A bill for $623 for the city's services arrived at her home 11 months later.
"We paid it because we were billed for it. It was our responsibility," Mrs. Selleck said. "I don't necessarily agree with it because that is what you pay taxes for. You just want to go on with your life."
Cost Recovery's Ms. Moore maintains that insurance policies have broad liability that requires them to pay for all costs emanating from responding to a car accident, including services such as "directing traffic" and "establishing a safety zone."
"They have a very broad umbrella under liability. There's a great deal of other things the insurance companies pay for that are not line itemized," Ms. Moore said.
Ms. Moore said the company provides some additional information when an individual or insurance company inquires. But she said that typically insurance companies are just trying to stall paying.
According to the Ohio Insurance Institute, at least 28 other political subdivisions have adopted accident response fees, including Cincinnati, Cleveland, Dayton, and Lima.
Council President Ludeman said he may ask council to hold a public hearing on the accident fee program within 30 days to see how it's working.
He cast the sole "no" vote against the legislation when it was approved, and said the complaints that he's heard about the fees since its implementation have affirmed his doubts.
"I thought it was a double hit. I just didn't feel it was right," Mr. Ludeman said. "I think we ought to be able to run the city properly with our normal revenue stream."
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