We are as vigilant as possible in reviewing renewal data, and looking for high paramedical claims that may indicate fraud. We educate clients, and have several each year that inform us of suspicious behaviour by employees (often TOO GOOD TO BE TRUE offers).
We call fraud lines from time to time to report, and often make plan design changes (read as benefit cuts) in an attempt to protect employers. The story below, shows how big the problem can become…
One of the fired employees said she began claiming for physiotherapy she did not receive because she was paying more each month into a benefits plan than she was actually using.
In what could be one of the largest and longest-lasting benefits fraud schemes ever discovered in Canada, a Toronto geriatric hospital has dismissed approximately 150 employees for falsely claiming as much as $5 million in benefits over an eight-year period.