Ontario's Auto Insurance Anti-Fraud Task Force

The Auto Insurance Anti-Fraud Task Force will examine the scope of auto insurance fraud in Ontario and make recommendations to the government regarding prevention, detection, investigation, enforcement and consumer education strategies.

Assisted by a steering committee, the task force will include representatives from the insurance industry, academia, the justice sector and consumers. The steering committee chair, Fred Gorbet, is independent from the insurance industry and the Ontario government.

Timelines

The steering committee will provide:

• A report outlining immediate action recommendations (Fall 2011)

• An interim research report on auto insurance fraud in Ontario (Fall/Winter 2011)

• A final research report on auto insurance fraud in Ontario (Spring 2012)

• An interim task force progress report (Summer 2012); and

• Final recommendations to the Ontario government (Fall 2012)

Items To Be Addressed By Steering Committee Research 

1.  The nature and extent of criminal and opportunistic auto insurance fraud in Ontario, including:

• The financial cost of auto insurance fraud in Ontario, including the costs of criminal and opportunistic fraud in personal injury claims and fraud in non-personal injury coverages, such as vehicle repair;

• The territorial distribution of fraud within Ontario (e.g. the incidence of fraud in the GTA compared with the incidence of fraud in other urban centres and rural areas);

• The extent of the migration of staged accident rings to Ontario from other jurisdictions and its costs and effects for Ontario's drivers;

• The best anti-fraud practices in place in other jurisdictions;

• Fraud in personal injury coverages, such as the overuse of medical and rehabilitation benefits or the padding of originally legitimate medical and rehabilitation claims by health care providers/clinics; and

• Fraud in non-personal injury coverages, such as vehicle repair.

2.  Auto insurance anti-fraud strategies, policies and best practices implemented by other jurisdictions in the area of consumer engagement and education practices.

3.  Any other area of related research identified by the steering committee.

 Task Force Working Groups

The research conducted by the steering committee will support the work of the task force working groups, who will assist the committee in developing its final auto insurance fraud prevention recommendations.

The working groups will consist of stakeholders and government representatives, including regulators, law enforcement, insurers, insurance intermediaries, health care providers and legal professionals. They will focus on developing collaborative approaches and solutions to specific auto insurance fraud issues, such as consumer engagement and education.

Initiatives To Eliminate Auto Insurance Fraud

The task force builds on a number of other initiatives the government has done to help the insurance industry and the Financial Services Commission of Ontario address fraud, including:

• Bringing in reforms in September 2010 to combat the fraud and abuse that have been undermining the auto insurance system by targeting excess assessment costs and overuse of minor injury treatments;

• Working with the insurance industry to use the newly established Health Claims for Auto Insurance database to detect potentially fraudulent activity; and

• Introducing new rules to ensure that treatments are provided as invoiced.