In Canada you'd assume insurance is lower because you get basically nothing for emotional damages, whereas in US the vast majority awarded is for emotional, how

In Canada you'd assume insurance is lower because you get basically nothing for emotional damages, whereas in US the vast majority awarded is for emotional, however Canada being relatively rich means we get fleeced more and also the arguable excuse due to economies of scale - being 1/10th the population of the US. If insurance was kept honest, if it was a true free market system where there was an immutable ledger where all insurance companies in real time had to post every action/response they make as to who/what they approve/deny/delay etc, then competitors could come in when they notice how many billions of profits there are each year - meaning that more people or procedures could be covered. But yes, there are multiple industrial complexes playing together to maintain the status quo.