Auto insurance fraud targets health care system
Admin
(NC)—Health care practitioners are on high alert to pinpoint and prevent identity theft. Common scams involve fraudsters stealing signatures, forms, and patient information to bilk payments from auto insurance companies.
This type of fraud is currently on the front burner of the insurance industry regulator, the Financial Services Commission of Ontario (FSCO) with its recent initiatives to assist, guide and protect health care professionals from becoming targets. Take a look at the recently launched e-brochure on this topic easily downloaded at fsco.on.gov.ca. In the Auto Insurance section look for the publication Insurance Abuse and Fraud in Health Care Services: Everyone Has A Role To Play.
You will see that through the illegal use of a practitioner’s name (or other identifiable information) fraudsters have been obtaining payments for health care services that were never provided. As the fraud is uncovered, the practitioner unwittingly becomes the subject of a police investigation leading to any number of consequences, from reputation damage to legal costs. As well, every Ontarian is a potential target because patient information is also being used to falsify the claims.
Warning signs
With heightened awareness of such scams, health care practitioners are advised to be on watch for suspicious documents and suspicious activities. Other advice includes: never sign blank treatment and assessment documents; always maintain exact records of the treatments provided; always record payment decisions made by insurance companies; never give personal information to a third party for processing invoices; always inform the Regulatory College when relocating; and immediately report suspicious activity. Each health care practitioner should be a gatekeeper to prevent identity fraud.
FSCO reports that the government’s Auto Insurance Anti-Fraud Task Force is examining the scope of insurance fraud in Ontario. Building on current government initiatives, representatives from the insurance industry, academia, justice and the public are addressing, among other priorities, the nature and extent of such criminal activity, as well as proven strategies to curtail this opportunistic activity.
