Fraud (Dutton Brock)

THE “F” WORD
IS FRAUD A RISK?
CHRISTOPHER R. DUNN
DUTTON BROCK LLP
WHAT IS INSURANCE FRAUD?
 Any act or omission with a view to illegally
obtaining an insurance benefit
 Fraud is perceived as the quintessential
“victimless” crime
2
TYPES OF INSURANCE FRAUD:
Auto
Business losses
Commercial
Life/disability
3
FRAUD STATISTICS:
 Insurance fraud costs Canadian insurer’s an
estimated $1.3 billion (cdn.) each year
 10% to 15% of insurance premiums for auto,
home and business insurance go to pay for
false or exaggerated claims
 Ontario is a hotbed for insurance fraud
4
FRAUD MANAGEMENT (pre-litigation):
Indicators and Awareness
Quality controls
Profiling/Scoring
Hand-off procedures
Specialists
5
WHAT IS THE ANSWER (post-litigation)?
Surveillance
Internet searches, ie. Facebook
Examinations Under Oath
Ontario Rules of Civil Procedure
Learning from the ICBC model
6
Questions?
Thank you!

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