FSCO cracks down on fraud

Owen Giddens and Ontario Disability charged with making false or misleading statements to auto insurers.

The Financial Services Commission of Ontario (FSCO) has charged Owen Giddens with six counts of knowingly making false or misleading statements to an auto insurer to obtain payment for goods and services provided to an insured. The first appearance for this matter is scheduled for September 29, 2011.

The agency has also charged Ontario Disability Management Inc. and Aksana Miakouchkina (also known as Roxanne Mitch) with knowingly making false or misleading statements to an auto insurer to obtain payment for goods and services provided to an insured. Additionally, FSCO has charged Gregori Miakouchkine, the company’s director, with authorizing or permitting the company to make false statements and with failing to take reasonable care to prevent the company from doing so. The first appearance for these matters is scheduled for October 13, 2011.

“FSCO has zero tolerance for those who abuse the system and drive up premiums. FSCO will prosecute those who submit false claims,” said Philip Howell, CEO and superintendent of FSCO in a media release.

Auto insurance fraud has become a major financial problem for both insurance companies and consumers, stated the release. Every time an insurance company pays a fraudulent claim, it increases its cost of doing business, which in turn is reflected in higher premiums.

To combat this, the Government of Ontario has established an Auto Insurance Anti-Fraud Task Force to determine the scope of auto insurance fraud in the province and to make recommendations on detection, investigation, enforcement and consumer education.

Insurers have rights and responsibilities under the Statutory Accident Benefits Schedule (SABS) to challenge questionable or abusive claims, including verifying invoices and expenses. Ontario auto insurers will be required to annually attest that their companies have established effective compliance controls to satisfy the rules that protect the rights of policyholders and accident victims.

Additionally, as of February 1, 2011, all Ontario health care facilities or providers were required to transmit auto insurance claim forms to insurers through Health Claims for Auto Insurance (HCAI). This database will help to detect auto insurance abuses.

To read about insurers’ rights and responsibilities to challenge questionable or abusive claims, click here.

To find out more about the Auto Insurance Anti-Fraud Task Force, click here.

To learn more about FSCO’s enforcement activities, click here.

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Transcontinental Media G.P.