TORONTO, July 23, 2014 /CNW/ - Ontario Rehab Centre, a Toronto-area rehabilitation clinic, has been convicted of auto insurance offences resulting from co-operative investigations involving the Financial Services Commission of Ontario (FSCO), the Insurance Bureau of Canada, multiple insurers, and the Toronto Police Service.
Ontario Rehab Centre was charged with two offences under the Insurance Act:
- Knowingly making false representations to State Farm to obtain payments for services provided to auto insurance claimants; and
- Charging amounts to State Farm for the payment of services that were not provided.
The Ontario Court of Justice found Ontario Rehab Center guilty on both counts and imposed the maximum fine of $100,000 on each of the charges, for a total of $200,000 in fines.
The court also ordered that the clinic provide restitution to State Farm for amounts that were proven to have been falsely billed and paid, in the amount of $609,112.
The conviction stems from an investigation into a staged auto accident ring, dubbed "Project Whiplash" by Toronto Police. According to the Insurance Bureau of Canada, insurers paid out an estimated $4 million in fraudulent claims as a result of this scam.
FSCO encourages anyone with information about auto insurance fraud to call its anonymous tips line (1-855-5TIP-NOW). The public can also submit anonymous tips to FSCO online through its website.
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, mortgage brokerages and administrators, and service providers who invoice auto insurers for statutory accident benefits claims.
FSCO investigates allegations of misconduct, unfair practices and non-compliance with legislation or regulations in its regulated sectors. When warranted, FSCO takes enforcement action.
As other Insurance Act and related criminal prosecutions remain before the courts, there will be no further comment on the convictions from FSCO.
- "Auto insurance fraud costs all drivers in the form of higher auto insurance premiums. Fraud will not be tolerated, and FSCO is committed to prosecuting these abuses" – Philip Howell, CEO and Superintendent of FSCO.
- Ontario's Auto Insurance Anti-Fraud Task Force was announced in the 2011 Budget. The Task Force was established in July 2011 and submitted its final report to the government in November 2012. The report contained 38 targeted recommendations on four key areas: fraud prevention, detection, investigation and enforcement and regulatory roles and responsibilities.
- Through amendments to the Insurance Act (Bill 65) in June 2013, the government established the legislative framework for FSCO to license health clinics that invoice auto insurers and regulate their business practices. The licensing and regulation of health clinics was a key Task Force recommendation, and it becomes effective December 1, 2014.
- As the next step in the Auto Insurance Cost and Rate Reduction Strategy, the government introduced the Fighting Fraud and Reducing Automobile Insurance Rates Act, 2014 on July 15, 2014. If passed, it would protect consumers and continue its crackdown on auto insurance fraud by:
- Transforming Ontario's auto insurance dispute resolution system (DRS) to help injured Ontario drivers settle disputed claims faster.
- Regulating the towing and vehicle storage industries through measures that tackle questionable practices.
- Giving the province authority to change the current 60-day period that a vehicle can be stored after an accident, accruing charges, without notice to the owner.
SOURCE: Financial Services Commission of Ontario
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