Insurance Fraud – Get in the Know

Insurance fraud is an ongoing problem in Canada. Fraud is not a victimless act – it affects us all. Insurance crime is not victimless. The cost to Ontario is estimated to be 1.6 billion a year in insurance premiums and health care, emergency services and court costs.

Thankfully the Insurance Bureau of Canada (IBC) is there to investigate insurance crimes and to educate Canadians about the associated costs and consequences. IBC is also lobbying for legislative changes to increase the risk and decrease the profit associated with insurance fraud.

According to a poll conducted by Pollara for IBC…  

• 50% of Ontarians have heard of or have experienced a staged car collision resulting in false claims for injuries and damage to cars.

• 57% of respondents have heard of or have experienced a specific case in which a health care provider billed an insurance company for services they never provided.

• 47% of those questioned have heard of or have experienced a specific case in which a health care provider charged more for treatments that were being paid for by insurance.

• 62% of Ontarians have heard of or have experienced a specific case in which a health care provider exaggerated the severity of a patient’s accident injuries so they could receive extra treatments (paid for by insurance, of course).

I was really surprised to read these stats but then I started thinking about my own experiences.   I remembered the auto body repair shop that handled a hit and run accident I was in where the repairer half-seriously, half-jokingly mentioned I should include my front bumper in the repair and have the insurance company cover it.  Um no.  

I also remembered the time some guy cut me off and then immediately braked and hard so that I rear-ended him despite braking as hard as I could.  There was no damage to either vehicle aside from a plastic decoration on his tow hitch.  He immediately tried telling me I wasn’t paying attention and talking down to me like I was a kid.  He then offered to take $20 if he didn’t put through an insurance claim.  Instead I called my insurance broker immediately and explained what happened.  He tried to put through a claim but I am not sure what happened with it.  Hopefully the insurance broker saw through his claim. 

Insurance fraud is more than organized auto theft or insurance fraud rings. It’s also fraud to: 

 

• Include pre-collision damage in an auto insurance claim.
   
• Claim property items not stolen or damaged during a break-in.
   
• Exaggerate injuries following a collision in order to collect benefits.
   
• Make an insurance claim for an event that never happened (collision, break-in, etc.).
   
• Offer or accept “free” treatment for an injury unrelated to a collision.
   
• Charge an insurance company for treatments that never happened (through a health care facility).
   
• Encourage anyone to participate in fraudulent activity (through a legal representative).

 

What happens when a fraud is reported?

 

• A report is made through the anonymous tip line 1-877-422-TIPS or reported online 

• The investigator follows up on the tip and completes an investigation 

• If a fraud has been committed, criminal charges may be laid

 

What reporting fraud can help:

• Keep premiums down
   
• Bring offenders to justice
   
• Make our roads safer
   
• Make potential criminals think twice, and help keep insurance affordable for honest policyholders
   
• Prevent crime

 

If you have information about an insurance crime, report it online or call 1-877-422-TIPS.

Disclosure:  The opinions and language are all my own, and in no way do they reflect Insurance Bureau of Canada.