Aviva Canada gets action in undercover auto insurance fraud case | Canadian Insurance

Aviva Canada gets action in undercover auto insurance fraud case

Toronto clinic employees and paralegal receive convictions, license suspensions

Aviva Canada says two individuals at a Toronto wellness clinic and a paralegal have been found guilty of auto insurance fraud in what the insurer is calling the first undercover insurance investigation of its kind in Canada.

The case—which led to Toronto Police executing search warrants in March of 2016—revealed collusion between Wellness Centres of Ontario and Kovtman Law, a Toronto law firm, after Aviva outfitted undercover investigators to pose as injured motorists seeking auto insurance injury benefits.

Related: Auto repair fraud costs Ontarians $547 million annually: Aviva Canada

Edward Hayes, a licensed chiropractor, Michelle Osacenco, a clinic employee and Anna Kovtanuka, a paralegal, have since been handed down various fraud-related convictions

“Those investigated were trusted professionals who took advantage of Ontario insurance consumers by taking money set aside by insurance companies to treat customers with real injuries,” Christopher Lang, Aviva Canada’s senior manager of fraud operations, said in a news release. “Without the undercover investigation, this situation would likely have continued because of a diminished level of proof. We believe the problem to be pandemic.”

The case also spurred provincial regulators into action. Kovtanuka’s paralegal license has been revoked, while the Financial Services Commission of Ontario (FSCO) issued both monetary penalties against the wellness clinic and its owner, as well as an interim order for it to cease operations. Hayes’s chiropractor’s license was initially suspended; since then, a College of Chiropractors of Ontario committee has found him guilty of eight counts of professional misconduct.

Aviva Canada says cases like this and other types of auto insurance fraud are estimated to cost Canadians $2 billion annually. The insurer is calling for the implementation of its six-point plan, which includes assigning regulators the responsibility for fighting fraud; accurately tracking and reporting on fraud; implementing the Marshall Report; banning referral fees; taking cash settlements out of the system; and holding regulated professional bodies accountable for quicker reviews of fraud complaints.

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