Canadian Underwriter

Aviva Canada announces three separate fraud cases in Toronto area

September 11, 2015   by Canadian Underwriter

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The Greater Toronto Area (GTA) continues to be the epicentre of insurance fraud, which contributes to higher insurance premiums for Ontarians, Aviva Canada said on Friday after announcing three separate cases in the region.

One case involved a doctor whose licence was suspended for nine months

Aviva Canada, a provider of home, auto, recreational vehicle, group and business insurance, said in a press release on Friday that insurance fraud is estimated to cost several billion dollars a year in insurance premium, healthcare, emergency service and court costs.

The insurer said in the release that in September of 2014, Bill’s Midway Auto Body owner Peter Panagopoulos filed a claim with Aviva Canada for parts allegedly stolen from a vehicle insured under his business, an auto collision repair facility in Toronto’s east end. Aviva Canada investigated the claim and noticed inconsistencies in the invoices submitted by Panagopoulos. The insurer questioned the inconsistencies and alleged that the auto parts were never stolen and Panagopoulos reported a fraudulent claim, hoping to be paid a cash settlement.

Panagopoulos was charged with fraud over $5,000, uttering forged documents and public mischief. He was scheduled to appear in court on Friday.

In another case in 2014, Aviva Canada received information alleging that Chad Wayne Sweet, an individual unlicensed and unauthorized to sell insurance, had allegedly lured and counselled policyholders to commit fraud, by using false information to obtain cheaper auto insurance premiums, the release said. Sweet allegedly received compensation from the policyholders by charging a fee to set up the policies with various companies, including Aviva Canada.

Aviva Canada said that it investigated the case for nearly a year, alleging that Sweet impersonated a policyholder when setting up the policies. The total cost of the premium difference for the policies affected is $5,697.

The Toronto Police Service continues to investigate other potential leads. Sweet has been charged with six counts of fraud under $5,000 and five counts of possession of proceeds of property obtained by crime. He is scheduled to appear in court on Oct. 6.

“The implications of setting up policies with incorrect information are that the insured persons – whether they are willing co-conspirators or innocent victims – are not covered under a legitimate policy and may be personally liable for damage and injuries arising from their claims,” said Irene Bianchi, executive vice president, National Claims for Aviva Canada, in the release. “This can leave them out of pocket thousands of dollars.”

The third case dates back to 2012, when Aviva Canada began an investigation into one of its service providers, Dr. Kevin Bar, a licensed practitioner of chiropractic medicine. Following the investigation, the insurer alleged that Dr. Bar was complicit in, or directly responsible for, the submission of insurance documents following a staged motor vehicle accident. The insurer further alleged that Dr. Bar failed to maintain clinical notes and records for treatments he claimed to have provided.

The College of Chiropractors of Ontario also investigated the matter and suspended Dr. Bar’s licence for nine months.

“We are pleased with this landmark outcome for Aviva Canada and indeed the Canadian property and casualty insurance industry as a whole,” Bianchi said.

While the CCO ruling was an important one, Aviva Canada will also be seeking regulatory action by the Financial Services Commission of Ontario and requesting a criminal investigation by local authorities.

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