Insurance Fraud in Canada
TABLE OF CONTENTS
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SECTION 1: AN INTRODUCTION TO INSURANCE FRAUD |
1 |
|
WHAT IS THE FINANCIAL IMPACT OF INSURANCE FRAUD? |
3 |
|
TOP THREE INDUSTRIES AFFECTED BY INSURANCE FRAUD |
4 |
|
HEALTHCARE |
4 |
|
WORKER'S COMPENSATION |
5 |
|
AUTO INSURANCE |
6 |
|
SECTION REVIEW |
7 |
|
SECTION 2: A CLOSER LOOK AT INSURANCE FRAUD |
8 |
|
HARD FRAUD: DELIBERATE AND DAMAGING |
8 |
|
SOFT FRAUD: AN OPPORTUNITY TO GET MORE |
9 |
|
WHO CAN COMMIT INSURANCE FRAUD? |
9 |
|
REAL-LIFE EXAMPLES: THE SMALL |
10 |
|
REAL-LIFE EXAMPLES: THE BIG |
12 |
|
REAL-LIFE EXAMPLES: THE UGLY |
16 |
|
SECTION REVIEW |
27 |
|
SECTION 3: UNDERSTANDING FRAUDSTERS AND INSURANCE FRAUD |
28 |
|
WHY DO PEOPLE COMMIT INSURANCE FRAUD? |
28 |
|
COMMON TYPES OF INSURANCE FRAUD |
32 |
|
COMMON INSURANCE FRAUD SCHEMES IN HEALTHCARE |
32 |
|
BILLING FOR SERVICES THAT WERE NOT PROVIDED |
32 |
|
UPCODING |
33 |
|
UNBUNDLING |
34 |
|
COMMON INSURANCE FRAUD SCHEMES IN WORKERS' COMPENSATION |
36 |
|
PREMIUM FRAUD |
36 |
|
CLAIMS FRAUD |
38 |
|
COMMON INSURANCE FRAUD SCHEMES AUTO INSURANCE |
40 |
|
SECTION REVIEW |
42 |
|
SECTION 4: FRAUD DETECTION— HOW TO FIGHT AGAINST INSURANCE FRAUD |
43 |
|
DETECTING AND MANAGING RED FLAGS |
43 |
|
COOPERATION WITH GOVERNMENT AND LAW ENFORCEMENT AGENCIES |
45 |
|
USE OF TECHNOLOGY TO FIGHT FRAUD |
46 |
|
THE STATE OF FAUD TECHNOLOGY STUDY: ANTI-FRAUD TECHNOLOGIES |
47 |
|
SECTION REVIEW |
51 |
|
SECTION 5: PRACTICAL HELP— WAYS TO PROTECT YOURSELF FROM FRAUD |
52 |
|
4 SIGNS THAT YOU'RE GETTING SCAMMED |
52 |
|
PRACTICAL STEPS TO PROTECT YOURSELF FROM FRAUD |
53 |
|
SAFEGUARD YOUR PERSONAL INFORMATION |
54 |
|
UTILIZE TECHNOLOGY TO YOUR ADVANTAGE |
54 |
|
USE COMMON SENSE |
55 |
|
SECTION REVIEW |
55 |
|
COURSE REVIEW |
57 |
|
SECTION 1: AN INTRODUCTION TO INSURANCE FRAUD |
57 |
|
SECTION 2: A CLOSER LOOK AT INSURANCE FRAUD |
59 |
|
SECTION 3: UNDERSTANDING FRAUDSTERS AND INSURANCE FRAUD |
60 |
|
SECTION 4: FRAUD DETECTION— HOW TO FIGHT AGAINST INSURANCE FRAUD |
61 |
|
SECTION 6: PRACTICAL HELP— WAYS TO PROTECT YOURSELF FROM FRAUD |
61 |
|
REFERENCES |
63 |
United Insurance Educators, Inc.