The cost of fraud: we all pay
April 2011
The Co-operators is committed to preventing insurance fraud. It is an unfortunate reality that some people look for ways to exploit our plans. Fraud will cause increased costs, or decreases in benefits in efforts to control costs for all of our partners and clients. We want to ensure your group clients are protected so please read on for further steps we are taking and how you can help.
We have controls in place and staff dedicated to detecting fraudulent claims and preventing future losses so we can keep costs down for your valuable clients. We regularly enhance our programs and develop new measures to detect unusual patterns. Below are the various ways in which we are protecting your clients against fraud:
- Suspicious claims are investigated before they are paid and before they cost the plan money.
- We use technology which flags unusual submissions.
- Trained staff members watch for suspicious activities.
- We pursue referrals with law enforcement agencies and regulatory bodies.
- We are a member of the Canadian Health Care Anti-Fraud Association.
We can use your help too! Please ask your clients to keep the following in mind to help safeguard their plans:
- Support plan member education regarding suspicious activities.
- Understand the need for claims audits.
- Refer tips or information about suspected fraud to The Co-operators.
- Treat health care fraud as a serious matter.
- Plan design options can help prevent fraud.
We are committed to ensuring that your clients’ employee benefit plans are used appropriately so that they can continue to do what they were designed to do – provide coverage to support the health and well being of plan members and their families.
If you would like to discuss plan design options to help prevent fraud within your clients’ plans, please contact your local Group Business Development Manager.
If you have any questions on fraud, or if you would like to report suspected fraud, please contact our Group Client Service Centre at 1-800-667-8164.
