Anti-fraud task force calls for greater FSCO powers

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.

Sixteen 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.

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 health care 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. __

Other recommendations include improved consumer education, such as the creation of a new multi-lingual educational website and a fraud tip hotline run by FSCO. Greater information-sharing among organizations such as the Workplace Safety and Insurance Board (WSIB), and the Ontario Health Insurance Plan (OHIP) were also cited by the task force.