Aviva Canada investigation =
A lesson for law firms, legal representatives, healthcare clinics, healthcare professionals
April 5, 2018 (Toronto, ON) – The conclusion to an investigation involving legal and healthcare professionals is one more win in Aviva’s fight against auto insurance fraud on behalf of honest consumers everywhere. The reality remains that meaningful actions by government are needed to tackle root causes.
Concerned about the extent of fraud and abuse in the Ontario auto insurance injury sector, Aviva Canada outfitted undercover investigators with hidden recording equipment to test the business practices at Wellness Centres of Ontario, a healthcare clinic in Toronto. Posing as uninjured motorists seeking auto insurance injury benefits, the undercover investigators revealed collusion between the healthcare clinic and Kovtman Law, a Toronto law firm. In March 2016, Toronto Police Service executed search warrants and criminal charges were laid. This was the first undercover insurance investigation of its kind in Canada. Aviva Canada also presented their findings to regulatory bodies including the Financial Services Commission of Ontario (FSCO), the College of Chiropractors of Ontario (CCO) and the Law Society of Ontario (LSO).
Conclusion of criminal charges laid by Toronto Police Service:
- Edward Hayes (licensed chiropractor) pleaded guilty to one count of Fraud Under $5,000 and received a six-month conditional sentence and a twelve-month probation order.
- Michelle Osacenco (clinic employee) pleaded guilty to one count of Fraud Under $5,000 and received a conditional discharge, a 12-month probation order, and a $1,500 freestanding restitution order.
- Anna Kovtanuka (paralegal) pleaded guilty to one count of Attempted Fraud Under $5,000 and received a conditional discharge, a three-year probation order and a $1,000 freestanding restitution order.
“The facts in this investigation highlight typical abuse within Ontario’s auto insurance system, the cost of which continues to be a key contributor to rising premiums. The hidden cameras in this investigation give everyone a glimpse into white collar crime in this sector,” said Christopher Lang, Senior Manager, Fraud Operations, Aviva Canada.
Actions taken to date by provincial regulators:
- On November 20, 2017 Ms. Kovtanuka’s paralegal license was revoked by the Law Society of Ontario.
- The College of Chiropractors of Ontario (CCO) initially suspended Dr. Hayes’ chiropractor license. In late 2017, a CCO Committee completed a review and found that Dr. Hayes committed 8 counts of professional misconduct. A final disciplinary decision has yet to be announced.
- The Financial Services Commission of Ontario issued an interim order to the Wellness Centres of Ontario to cease operations, and imposed an administrative monetary penalty of $21,985.17 against the clinic. Tatiana Amelian (clinic owner) also received an administrative monetary penalty of $4,000.
In Ontario, there is one private healthcare provider for every two people injured in a car accident and the number of personal injury legal representatives is on the rise.
Christopher Lang continued:
“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. Without the undercover investigation, this situation would likely have continued because of a diminished level of proof. We believe the problem to be pandemic.”
Auto insurance fraud is estimated to cost Canadians $2 billion annually. More needs to be done by the Ontario government to help tackle the root cause in the injury sector of its auto insurance system. Aviva Canada recommends a 6-point plan:
- Assign responsibility for fighting fraud to regulators.
- Accurately track and report on fraud and our progress in fighting it.
- Implement the Marshall Report
- Ban referral fees
- Take cash settlements out of the system.
- Hold regulated professional bodies (legal and healthcare providers) accountable for swifter reviews of fraud complaints.
Learn more about our recommendations to government and how to protect yourself from auto insurance fraud at www.avivacanada.com/fightfraud. Aviva Canada customers who suspect they may have been a victim of fraud can contact the 24/7 fraud hotline at: 1 855 332 5255. Or by email at: firstname.lastname@example.org.
About Aviva Canada
Aviva Canada is one of the leading property and casualty insurance groups in the country, providing home, automobile, leisure/lifestyle and business insurance to 2.8 million customers. A subsidiary of UK-based Aviva plc, Aviva Canada has more than 4,000 employees focused on creating a bright and sustainable future for our customers and our communities.
Aviva Canada invests in positive change through the Aviva Community Fund, Canada’s longest running online community funding competition. Since its inception in 2009, the Aviva Community Fund has awarded $8.5 million to over 280 charities and community groups nationwide. Aviva Canada, bringing over 300 years of good thinking and insurance solutions to Canadians from coast-to-coast.