IBC shines a spotlight on the huge problem of insurance fraud for Fraud Prevention Month

Toronto, ON (Feb. 27, 2014) – Insurance Bureau of Canada is taking an active role in the February 27 official kick-off of Don’t Be Scammed: Fraud Prevention Month 2014, as it joins forces with the Financial Services Commission of Ontario, Toronto Police Services and other organizations involved with fraud awareness.

The launch will take place at a Toronto area school tonight between 6 p.m. and 9 p.m. and consist of live-streamed presentations by all participants to alert Canadians on how they can protect themselves against different types of fraud. The public is encouraged to watch the social media outreach online and to follow the #Don’tBeScammed hashtag starting today at 6pm to obtain the live-stream link and to interact with event participants.

Other participants in Don’t Be Scammed include the Bank of Canada, Canadian Anti-Fraud Centre, Canadian Health Care Anti-fraud Association, Competition Bureau, Crime Prevention Association of Toronto, Financial Services Commission of Ontario, Investigation Counsel, Investor Education Fund, Mutual Fund Dealers Association of Canada, National Initiative for the Care of the Elderly, Ontario Ministry of Consumer Services, Ontario Securities Commission, Royal Canadian Mounted Police, Real Estate Council of Ontario, Toronto Catholic District School Board, Toronto Parks and Recreation, Toronto Police Service and Victim Services Toronto.

The serious issue of insurance fraud will be tackled in a presentation by Kathy Metzger, Investigator, Ontario Injury Rings Unit, IBC Investigative Services, and will zero in on the involvement of organized crime groups in staged collisions and fraudulent medical clinics and other service providers.

Later, IBC will host an online breakout session “Fraud: Amplifying a silent noise on social media” (7:30-8:30pm.) The session will inform interested members of the public about how to find information about insurance fraud, resources currently available to better educate yourself about fraudulent activity (including ibc.ca, Twitter and Facebook), the process for reporting suspected incidents, as well as tips on how to protect you from becoming a victim.

Insurance fraud is a huge problem in Canada. In 2012, the Ontario Automobile Insurance Anti-Fraud Task Force cited a study that estimated that automobile insurance fraud cost between $770 million to $1.6 billion per year – in Ontario alone. Insurance claims are paid for from the premiums of the many. “Fraud is a crime of deception, says Ms Metzger. “Fraudulent claims are made to look like real claims, and when they are undetected, they are paid as real claims. Paid for from the premiums that you and I fund – and a key reason why honest policyholders pay more than they should for auto insurance,” she adds.

IBC Investigative Services works with and on behalf of its member companies to investigate the involvement of organized crime groups in insurance fraud. In her presentation, Ms Metzger will explain that these groups look at fraud as a business, often planning staged collisions or having ownership or interest in service-providing companies that could profit from false insurance claims. These could include body shops, tow truck companies, legal representative firms, health clinics, assessment centres and other service providers alleging to provide housekeeping, care giving or attendant care services. The organized crime groups make a profit from each one of those areas.

Ms Metzger also makes reference to several examples of insurance fraud. There’s opportunistic fraud when a person makes exaggerated claims. For example, someone who was involved in a motor vehicle collision and claims to be injured when they are not. A person continuing to work while claiming accident disability benefits. Or someone who has had their car broken into and some minor things stolen, but when they make their claim to the insurance company, they claim for larger, more expensive items; such as a laptop, or golf clubs. “These exaggerated claims are considered fraud and are definitely part of the problem,” says Ms Metzger. “But the issue we’re facing is far more than that.”

She will then delve into the very serious issue of insurance fraud by unscrupulous medical clinics. Here’s how one scam might work: A person injured in a motor vehicle accident would walk into a clinic and be seen by someone purporting to be a health professional. He or she is assessed and told that they would benefit from treatment. They are asked to sign incomplete or blank forms after being told that it would save time if the clinic completed them later. The person may be asked to sign a sign-in sheet, but may be told that it will save time on future visits if they sign for days in advance of attendance. The person continues to go for treatment until they feel better, and then they stop. However, the health clinic, having the person’s name and signature on blank forms, continues to submit requests for additional treatment and assessments to their insurance company.

“Fraud is a serious offense that affects us all,” says Ms Metzger. “By being aware that it is there and we could all become a victim, is the first step to preventing or reducing fraud from occurring. By working together – the industry, the consumers, and the government – we may be able to make it more difficult for organized groups to make us victims.” She urges Canadians to take the time to report insurance crime if they suspect it is taking place. They can call IBC’s confidential 1-877-IBC-TIPS or visit IBC on-line and follow the links. Or they can contact Crime Stoppers.

Tips to protect you from becoming a victim of insurance fraud in a health clinic:

  • If you are injured in a collision, see your family doctor. Involve them in your recovery.
  • When you do attend a clinic – ask for the credentials of the person treating you. Often they are posted – make sure you check them, and if you can’t find them, ask to see them. You may want to check on-line or with the Professional College, for a status of the provider.
  • Never sign blank forms or blank sign-in sheets.
  • Ask your insurance adjuster for a summary of the amount paid on your claim on a regular basis.
  • Keep your own records as to what treatment you receive from whom and when.
  • Be actively involved in your claim and aware of what is being claimed and paid for by you and all payers.

About Insurance Bureau of Canada

IBC is pleased to celebrate 50 years as a valuable resource for insurance information. Since 1964, IBC has worked with governments across Canada to make our communities safer, championing issues that directly affect Canadians and the property and casualty (P&C) insurance industry. IBC is the national industry association representing Canada’s private home, car and business insurers. Its member companies represent 90% of the P&C insurance market in Canada. The P&C insurance industry employs over 118,600 Canadians, pays more than $7 billion in taxes and levies to the federal, provincial and municipal governments, and has a total premium base of $46 billion.

To view media releases and information, visit the media section of IBC’s website at www.ibc.ca.