GTA Rehabilitation Clinics, Clinic Owners and Directors Face 28 Charges Related to Submitting False Invoices to Insurers for Payment
Admin
February 23, 2012. Toronto – The Financial Services Commission of Ontario (FSCO) has charged four rehabilitation clinics and six individuals affiliated with these clinics with offences under Ontario’s Insurance Act. These clinics and individuals are alleged to have submitted false invoices to insurers as part of a staged auto accident ring.
On February 23, 2012, the following clinics were charged with one count each of knowingly making false or misleading statements to an auto insurer to obtain payment for goods and services provided to an insured and engaging in an unfair or deceptive act or practice:
- McCowan Rehabilitation Clinic (1583 Ellesmere Road, Suite 104, Scarborough, Ontario)
- Ontario Rehabilitation Clinic (3031 Markham Road, Suite 31, Scarborough, Ontario)
- Physiotherapy Clinic (1920 Ellesmere Road, Suite 110, Scarborough, Ontario)
- North York Health & Rehabilitation Centre (1280 Finch Avenue West, Suite 519, Toronto, Ontario)
Several individuals affiliated with these clinics were also charged with the following offences:
- Vishnukanthan Sabapathy (four counts each of: knowingly making false or misleading statements to an auto insurer to obtain payment for goods and services provided to an insured and engaging in an unfair or deceptive act or practice pertaining to each of the four rehabilitation clinics identified above)
- Thayalan Thamootharampillai (one count each of: failing to take reasonable care to prevent the company from making false statements to an insurer and from engaging in an unfair or deceptive act or practice)
- Jeyakanthan Thivendran (one count each of: failing to take reasonable care to prevent the company from making false statements to an insurer and from engaging in an unfair or deceptive act or practice)
- Sujeegah Kanagalingam (one count each of: failing to take reasonable care to prevent the company from making false statements to an insurer and from engaging in an unfair or deceptive act or practice)
- Sipaskaran Sabaratnam (one count each of: failing to take reasonable care to prevent the company from making false statements to an insurer and from engaging in an unfair or deceptive act or practice)
- Nishanathan Ponnuthurai (one count each of: failing to take reasonable care to prevent the company from making false statements to an insurer and from engaging in an unfair or deceptive act or practice).
The Toronto Police Service has also laid criminal charges in relation to these matters.
FSCO investigates allegations of misconduct, unfair practices and non-compliance with legislation or regulations in its regulated sectors. When warranted, FSCO takes enforcement action.
FSCO is an agency of the Ministry of Finance established under the Financial Services Commission of Ontario Act, 1997. It regulates insurance, pension plans, loan and trust companies, credit unions and caisses populaires, co-operative corporations and mortgage brokerages and administrators in Ontario.
QUOTES
“Auto insurance fraud and accident benefit abuses cost all drivers. Fraudsters’ schemes take money out of the pockets of consumers by driving up auto insurance premiums. Today’s actions should send a strong message that fraud will not be tolerated.” – Philip Howell, CEO and Superintendent of FSCO
QUICK FACTS
- Auto insurance fraud has become a major financial problem for both insurance companies and consumers. Every time an insurance company pays a fraudulent claim, it increases its cost of doing business, which in turn is reflected in higher premiums.
- The Government of Ontario has established an Auto Insurance Anti-Fraud Task Force to determine the scope of auto insurance fraud in the province and to make recommendations on detection, investigation, enforcement and consumer education.
- As of February 1, 2011, all Ontario health care facilities or providers were required to transmit auto insurance claim forms to insurers through Health Claims for Auto Insurance (HCAI). FSCO is working with the Task Force to investigate how HCAI could be used to detect and prevent fraud.
- Insurers have rights and responsibilities under the Statutory Accident Benefits Schedule (SABS) to challenge questionable or abusive claims, including verifying invoices and expenses.
Source: http://www.fsco.gov.on.ca
