Canadian Life And Health Insurance Industry Launches National Campaign To Combat Fraud

The life and health insurance industry has stepped up its efforts in the fight against fraud by launching the Fraud=Fraud campaign to raise the level of consumer education and awareness around health and dental benefits fraud. Its goals are to help Canadians to recognize fraud, understand how to avoid becoming involved in fraudulent activities, and increase awareness that fraud is a crime and, therefore, has real consequences.

“Benefits fraud is far more widespread than it should be, in part because many people don’t understand that it is an actual crime,” notes President and CEO of the Canadian Life and Health Insurance Association (CLHIA) Stephen Frank. “Most people think that, if you are caught, you would just repay the money. In fact, you could not only lose your benefits, but also your job and, in some cases, end up with a criminal record and even go to jail.”

75% of Canadians incorrectly believe that the only punishment for benefits fraud is having to pay higher premiums

Benefits fraud occurs when an individual intentionally submits false or misleading information about the health or dental benefits they received under their employer’s benefits plan. According to a March 2018 survey conducted by Environics Research for the CLHIA, 75 percent of Canadians incorrectly believe that the only punishment for benefits fraud is having to pay higher premiums, or being forced to reimburse claim payments.

Although there have been some cases where individuals did not understand that they were engaging in fraud, the industry is increasingly seeing evidence of organized crime or unscrupulous service providers getting involved and reassuring insurance claimants that what they’re doing is normal or that they’re entitled to the money. “We are seeing more of these schemes, which are resulting in companies having to lay off large numbers of staff, and that can have a huge negative impact. That is why we believe a campaign like this is timely and necessary,” adds Mr. Frank.

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