DAILY NEWS Nov 22, 2012 3:57 PM - 8 comments

Ontario anti-fraud task force calls for licensing clinics, greater power for FSCO in final report

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By: Harmeet Singh, Online Editor
2012-11-22

The Ontario Automobile Insurance Anti-Fraud Task Force has released its final report outlining nearly 40 recommendations, chief among them expanding the power of the province’s industry regulator, greater public disclosure on the part of insurers and licensing certain health clinics.

CollisionSixteen months after its inception, the task force steering committee has recommended the Ontario government amend the Insurance Act to allow the Financial Services Commission of Ontario (FSCO) greater power in investigating and enforcing fraud.

Background: Ontario Anti-Fraud Task Force interim report suggests working groups look into licensing health-care clinics, creating dedicated fraud investigation unit

Among other changes, the government could update the Insurance Act to allow FSCO to investigate and sanction “unfair or deceptive acts or practices” within organizations that might not currently be considered part of the insurance business under the Act, such as some healthcare providers, the report said.

FSCO should also be given authority to oversee and audit the business and billing practices of health clinics or other individual practitioners who invoice auto insurers, according to the report.

The Ontario government should consider changing FSCO’s mandate to reflect the new responsibilities, and commission an independent review of the updated regulator’s function within three years of changing its scope, the task force said. “FSCO will have to recognize that it will no longer be ‘business as usual,’” the report noted.

The committee has also recommended implementing licensing for health clinics that treat patients injured in auto accidents. The ownership, costs of services and potential for conflicts from such clinics should also be reported through a licensing process, the task force noted.

The committee has also recommended the government require insurers themselves to disclose publicly how they choose and assess certain service providers they send claimants to see, such as independent medical examiners, towing services and vehicle repair services.

Background: Anti-Fraud Task Force committee seeks public input on proposed measures to combat auto insurance fraud

Other recommendations include improved consumer education, including the creation of a new multi-lingual educational website and a fraud tip hotline run by FSCO.  

Car crashGreater information-sharing among organizations such as the Workplace Safety and Insurance Board (WSIB), and the Ontario Health Insurance Plan (OHIP). The task force also called upon other regulators and industry groups, such as medical colleges, to become more aware of auto fraud and do their own investigations.

In a statement following the release of the report, the Insurance Bureau of Canada said it is optimistic that the recommendations from the report will be implemented in the coming weeks and months.

“We are committed to working with government and all stakeholders to develop solutions to the many issues inherent in the current auto product,” it noted.



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