THE “F” WORD IS FRAUD A RISK? CHRISTOPHER R. DUNN DUTTON BROCK LLP

2 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

3 TYPES OF INSURANCE FRAUD: Auto Business losses Commercial Life/disability

4 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

5 FRAUD MANAGEMENT (pre-litigation): Indicators and Awareness Quality controls Profiling/Scoring Hand-off procedures Specialists

6 WHAT IS THE ANSWER (post-litigation)? Surveillance Internet searches, ie. Facebook Examinations Under Oath Ontario Rules of Civil Procedure Learning from the ICBC model

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