1

THE “F” WORD IS FRAUD A RISK?

CHRISTOPHER R. DUNN

DUTTON BROCK LLP

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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

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TYPES OF INSURANCE FRAUD:

AutoBusiness lossesCommercialLife/disability

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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

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FRAUD MANAGEMENT (pre-litigation):

Indicators and AwarenessQuality controlsProfiling/ScoringHand-off proceduresSpecialists

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WHAT IS THE ANSWER (post-litigation)?

SurveillanceInternet searches, ie. FacebookExaminations Under OathOntario Rules of Civil ProcedureLearning from the ICBC model

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Questions?

8

Thank you!