In what could be one of the largest and longest-lasting benefits fraud schemes ever discovered in Canada, a Toronto geriatric hospital has dismissed approximately 150 employees for falsely claiming as much as $5 million in benefits over an eight-year period.
As in previous scams of comparable size, such as the one discovered last year at the Toronto Transit Commission, this one involved misuse of prescription coverage for orthotics, knee braces, and compression stockings, but also physiotherapy.
Typically, a group of criminals know people in credentialed professions who are willing to participate in these schemes in exchange for cash, said Gary Askin, a former Waterloo Region police officer and now assistant vice president, fraud risk management at Sun Life, a large insurance provider. They seek out generous benefit plans, and often have a “predatory” recruiter among staff who can help employees rationalize the fraud. Basically, this is a con, he said, and when it goes bust, the providers are holding cash, and the paper trail points to the employee.
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