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'It’s a big problem': Association warns of health and dental benefits fraud
TORONTO -- An association representing providers of health and dental benefits is warning people to be honest when submitting their claims at the end of the year.
According to Stephen Frank, president of the Canadian Life and Health Insurance Association, benefits fraud drives up the costs of providing benefits for employers and employees. More workers are reporting other employees who are faking injuries to receive benefits,” he said.
“In some instances we will have people in the workforce calling us and going to their HR manager and saying I’m seeing something that's not right and I think you need to look into it" said Frank.
“We know it’s a big problem and we know it’s a big dollar amount.”
Insurance companies will payout $34 billion in health and dental benefits for Canadians this year. But Frank said that health and dental fraud is estimated to cost hundreds of millions of dollars a year.
Frank said that health and dental fraud is “really about misrepresenting the service you received to get a financial gain and people can be pretty creative on how they go about doing that."
Benefits fraud can be letting friends use your health or dental benefits, changing amounts and dates on receipts, submitting claims to multiple insurers and claiming prescription drugs on behalf of others.
The association wants employees to realize that health and dental fraud should not be taken lightly.
“People might think what's the big deal. You are just stealing from your insurance company. Well, it's a serious crime and you are going to get caught and you will lose your job" said Frank.
The association says it came forward at this time of year because people may be trying to use up all their benefits before the end of the year and it wants to caution people not to abuse the system as they could face consequences.
The group also says there are organized crime rings that have created fake providers that are issuing fake receipts. It wants to bring more attention to this issue in 2020.