Insurance Crime Takes Advantage of People at Their Most Vulnerable

Collaboration is our biggest strength and the proof can be seen in the success of Équité Association’s recent ‘Scams Leave Lasting Scars’ campaign.

The goal of the campaign was to leverage the momentum we have from combating auto theft to expand awareness to other forms of insurance fraud, focusing on the significant and often devastating human impact of these crimes.

We worked closely with our members to build a comprehensive resource library to educate agents, brokers and front line insurance experts to support a ground-up approach to identifying and preventing insurance crime. Recognizing the signs of insurance crime and fraud empowers honest, hardworking Canadians to take decisive action to protect themselves and avoid becoming a victim.

There is an often hidden and devastating impact to victims of insurance crime perpetrated by organized crime networks. These networks are specifically taking advantage of injured individuals for financial gain, while also diminishing trust in the healthcare industry. These frauds have been connected to insurance crimes including ‘crash for cash’ scams and accident benefits fraud. These criminals are trying to maximize insurance payouts by fraudulently billing for unnecessary assessments or overbilling for procedures not provided to the injured individual, which can lead to them maxing out the patient’s total pre-approved treatment amounts before they are fully healed.

In Équité’s experience, these organized crime networks are made up of dishonest individuals who know how to take advantage of people at their most vulnerable and often with substantial injuries. Unfortunately, this includes those with a duty to act with integrity, such as healthcare clinic owners, registered healthcare practitioners, lawyers and more. The accident benefits system relies on trust between patients, healthcare professionals, and the insurance industry. When this trust is broken, the human impact can be devastating.

These types of investigations are complex. Our investigators and data analysts work closely with members, law enforcement, regulators and professional colleges to coordinate complex investigations, provide education, and share fraud trends. With this intelligence, collectively, we can combat insurance crime in Canada.

Through this campaign, we saw the industry including our members, media and industry organizations come together to amplify important key messages. This campaign demonstrates that Équité continues to be the centre-point of collaboration, supporting the industry, in identifying, preventing and eradicating insurance crime.

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