They Cheat – You Pay!

Insurance fraud is an ongoing problem in Canada. In Ontario, the problem is especially bad. Fraud is not a victimless act – it affects us all. Our insurance premiums, and more importantly, our safety, are directly impacted by insurance fraudsters and their dishonest acts.

It’s a sad truth and an uglier reality. And no matter how you slice it – when they cheat, we pay.

The stats surrounding awareness and experience with insurance fraud are staggering, especially in Ontario.  Let’s look at a few stats from a poll recently conducted by Pollara for the Insurance Bureau of Canada.

According to the poll results in Ontario…

50% of Ontarians have heard of or have experienced a staged car collision resulting in false claims for injuries and damage to cars.

57% of respondents have heard of or have experienced a specific case in which a health care provider billed an insurance company for services they never provided.

47% of those questioned have heard of or have experienced a specific case in which a health care provider charged more for treatments that were being paid for by insurance.

62% of Ontarians have heard of or have experienced a specific case in which a health care provider exaggerated the severity of a patient’s accident injuries so they could receive extra treatments (paid for by insurance, of course).

With all these instances of fraud, it’s no wonder that when they cheat, you pay.

One of the best ways to avoid being a victim to insurance crime is to recognize the signs of fraud and help report it. Here are some precautions you can take when you’re on the road:

• Never tailgate; allow ample time to stop if the car ahead of you suddenly slams on its brakes.
• Look beyond the car in front of you while driving. Safely apply your brakes if you see traffic slowing.
• Be careful when making left turns. If a car with the right-of-way slows down and waves you on, you may be in danger. Refrain from crossing in front of them.

It’s always best to record the details of the collision while they are still fresh in your mind. You can use this handy collision report form.  I recommend keeping a copy with you at all times.

In the event of a collision:

• Get the other car’s license plate number. Also, count how many passengers were in the other car when the accident took place. If there were a lot of people in the car… like too many for the number of available seatbelts…you may be a victim of a scam. Get their names, phone numbers and driver’s license numbers. Later, you can compare this info to the info on the resulting claims, to make sure that all of the claimants were actually passengers in the car.
• Note descriptions of the passengers. Try to find some characteristic that distinguishes each passenger.
• Note how the passengers behave. Do they stand around and joke, but suddenly act injured when the police arrive?
• Take pictures of the other car, the damage it received and the passengers. Take pictures on your cellphone or keep a disposable or digital camera in your glove compartment for this purpose.
• Call the police to the scene if you suspect that you are a victim of a fraudulent collision. Get a police report with the officer’s name, even if the damage is minor. If the police report notes just a small dent or scratch, it will be harder for crooks to claim serious injuries or car damage later.
• Get involved if you’re a witness. Watch for the warning signs of a scam, and help the honest victim with details.
• Call IBC’s TIPS line if you suspect an insurance crime. The 24-hour toll-free number is 1-877-IBC-TIPS (422-8477). Give the location of the collision, the license plate number(s) of the car(s) involved, the names of people involved, the reason you think the collision is suspicious and as many other details as possible.

Hopefully you never have to use these tips. But, in the unfortunate case that you do, follow them like a checklist and don’t forget to fill out the collision report form. Together, we can help fight insurance fraud. After all, when they cheat, you pay.

Sometimes, tow truck operators are paid a referral fee by a repair or body shop – incentive to bring damaged vehicles to a particular shop.  The repair shop may then “pad” its bills to recover the referral fee, resulting in you and other insurance policyholders paying in the end. These tips will help you spot the few that cheat the system.

If you’ve been involved in a collision and an unsolicited tow truck driver pulls up to the scene, there are a few things you need to know.

Here are some handy tips from the Financial Services Commission of Ontario (FSCO). While the tips are from Ontario, the advice is universal:

• Make sure the tow truck has some kind of licensing number on its side before you use its services.
• Look to see if the tow truck is affiliated with a reputable company such as an automotive roadside assistance group or automobile association.
• Ask if the tow truck driver has a police contract.
• Listen for obvious clues. Does the driver recommend a particular repair facility without being asked? This might be an indication that a referral fee arrangement exists.
• Carefully read everything the tow truck driver asks you to sign.
• Ask that your vehicle be taken to a secure location where an adjuster or appraiser from your insurance company can have access to it.
• Contact your insurance company, if possible, for information on towing and where to take your vehicle to be repaired.
• Consider having your vehicle towed to a preferred vehicle repair shop. Some insurance companies use preferred repair shops where they have an agreement that guarantees your vehicle will be repaired to the highest possible standards. For more information, contact your insurance company.

Again, most tow truck drivers are honest and helpful, but sometimes, like in any industry, there can be bad apples. Use this check list and your best judgment to help reduce the chance of being a victim of fraud.

So far, we’ve provided tips to help you guard against insurance fraud, before a collision and in the immediate aftermath of a collision. Now, we’ll shed some light on what you should keep in mind in the days, weeks and months following a collision.

Here are a few tips to help you get in the know:

After a collision: –

• Contact your insurance company if a stranger tries to steer you to an unknown body shop, doctor, chiropractor or lawyer. Give officials the names, addresses and phone numbers of these service providers.
• See only medical and legal professionals you know and trust, or that are recommended by people you trust. Never take referrals offered by a stranger.
• Check out the doctor or lawyer. Contact your provincial medical licensing board to ensure that your doctor is licensed and that no complaints have been lodged against him or her.
• Know what your medical benefits are – what’s covered and what isn’t.
• Keep detailed records of your medical treatments. Include all dates, locations, who provided the treatments, what diagnoses and services you received, and what medicine, supplies or equipment were provided.
• Compare your records against the statements you receive to make sure the bills aren’t padded and that they don’t include treatments you didn’t receive. Are the treatment dates, doctor name(s), facility locations and medical services the same as you remember? Question your health provider and ask for clarification if you see problems or inconsistencies on your bills.
• Never sign blank insurance claim forms.
• Never give strangers your policy number, insurance ID number or any other information, especially if they offer you cash or free gifts, treatments or equipment.

I hope this series has been helpful and that you’re now more prepared to guard against and fight insurance fraud.

Information provided courtesy of The Insurance Bureau or Canada