Undercover investigation captures alleged car insurance fraud
Published Friday, March 11, 2016 6:12PM EST
Police have laid charges in an alleged insurance fraud case after viewing an undercover video also obtained by CTV News.
The video, obtained exclusively by CTV Toronto and W5, was captured by hidden camera at a Toronto clinic last year.
It was presented as evidence to Toronto police, who charged a chiropractor, paralegal and receptionist with fraud-related offences after looking into the case.
None of the allegations have been proven in court.
The video was captured by two undercover operatives hired by insurer Aviva Canada. They were hired to investigate reports of fraudulent claims, after a client told the company he no longer wanted to proceed with an accident claim.
Aviva told CTV that the man said his friend encouraged him to file claims for injuries, though he hadn't actually been injured. He then went to a North York clinic, but said he was not intending to receive treatment.
After the client told his broker about the scheme, Aviva decided to launch an investigation into the clinic. Two private investigators wore hidden cameras, and attended the wellness clinic and a nearby paralegal office to seek advice.
The video appears to show staff members "coaching" patients on how to get more out of their claims.
"What would you like me to do for you? Would you like to take some time off?" a chiropractor can be heard in one of the video clips asking an undercover investigator.
In another clip, the investigator is heard telling a paralegal that she is "not really hurt," and insisting she has no pain.
The paralegal is seen encouraging the undercover investigator to declare injuries, like headaches and stress.
She is heard telling the undercover patient, "The more money you get at the end, the better cheque I get."
Later, a receptionist is seen telling the man wearing the camera, "I have pain in my back, pain in my neck."
"I don't have pain," the fake patient says.
"I know you don't, OK?" she responds.
The receptionist was also caught on camera telling the patient to sign an attendance log for future treatments that he did not intend to receive. She stopped the patient at one point, handing him a different coloured pen.
"That is about as damning as it can get," Aviva investigator Gord Rasbach told CTV Toronto's Paul Bliss.
Rasbach is a former Toronto police detective, and now a vice president of the company. He told CTV that the undercover investigators were also advised to claim symptoms that were hard to disprove.
"Something you can't see. Headaches, sleep apnea, counselling someone not to go to work, or counselling someone to get someone from work to say they didn't work," Rasbach listed.
During the investigation, Aviva played along, writing cheques to the clinic for services that Rasbach knew had not been rendered.
After months, Rasbach took the video to Toronto police and reported the allegations. Police watched the video and launched an investigation into the Wellness Centres of Ontario clinic in the north end of the City of Toronto.
Police charged the chiropractor and receptionist with three counts each of fraud, and the paralegal was charged with two counts of fraud and possession of property obtained by crime. The three accused will appear in court on March 17.
Investigators said the Ontario College of Chiropractors is also conducting an investigation.
CTV's W5 went to the clinic to get a comment on the case, but staff refused.
Aviva public relations manager Glenn Cooper estimated that fraud costs the province approximately $1.2 billion per year, which drives up the rates of auto insurance in Ontario.
Cooper said the company has an anti-fraud team dedicated to tracking down false claims.
"I certainly hope we're going to make a dent in the fraud business. We're not stopping. We will catch you," he said.
"Our duty here is to protect our policy holders, and this is impacting them. So we do put in a good number of resources into our anti-fraud management team to weed out those stealing from the system."
Toronto police ask anyone with more information on the investigation to contact them at 416-808-3200, or call Crime Stoppers anonymously at 416-222-8477 (TIPS).
Documents in an alleged insurance fraud case are shown.