Why did the insurance adjuster take up acting? Because he was really good at “billing” the audience! 🎭
But jokes aside, what happens when an insurance adjuster crosses the line into fraud? Let’s dive into a case that’s causing quite a stir in Ontario.
The Financial Services Regulatory Authority of Ontario (FSRA) has accused Ulrich Fabrice Avognon of engaging in fraudulent activities by billing for services never rendered or provided at a substandard level. The FSRA has proposed a hefty $100,000 penalty and a compliance order to stop Avognon from acting as an insurance adjuster in Ontario.
How It Works:
Avognon allegedly exploited his position by inserting false charges into insurance claim files. He billed for services like towing, car storage, and rental cars—services that were neither required nor delivered to the insured. To carry out this scam, he created fake invoices and payees, inputting his own personal bank account information to funnel payments directly to himself.
Who’s Targeted:
This scam specifically targeted insurance companies and the claimants who trusted that their claims were being handled legitimately. The deception was carried out over several months, affecting numerous claimants who were likely unaware of the fraudulent charges being added to their claims.
Real-Life Example:
Between February 9 and May 25, 2023, Avognon made 99 fraudulent payments, totaling over $221,000, all directed into accounts he controlled. The FSRA alleges that these actions violated Ontario’s Insurance Act, leading to the proposed sanctions against him.
Why You Should Care:
Fraudulent activities like these undermine the integrity of the insurance system and can lead to higher premiums for everyone. If left unchecked, such scams could result in more stringent regulations and increased scrutiny on legitimate claims, making the process more cumbersome for honest policyholders.
How to Protect Yourself:
- Review Your Insurance Statements: Regularly check your insurance claim statements for any unfamiliar charges or services. If something doesn’t look right, contact your insurance company immediately.
- Verify Services Rendered: If you’re involved in an insurance claim, ensure that all billed services were actually provided. Don’t hesitate to ask for receipts or documentation.
- Stay Informed: Keep up with updates from regulatory bodies like the FSRA to be aware of ongoing issues and potential scams in the insurance industry.
- Report Suspicious Activity: If you suspect fraud, report it to your insurance provider or the appropriate regulatory authority. Early detection can prevent further damage.
- Ask Questions: Don’t be afraid to question charges on your insurance statements. A reputable adjuster or insurance company should have no issue explaining every charge.
Quick Tips & Updates:
- Pro Tip: “Did you know? Fraudulent activities in insurance often lead to higher premiums for everyone. Staying vigilant helps keep costs down.”
- Quick Tip: “Always verify the details of any services billed to your insurance claim. It’s your right to know where your money is going.”
Your Turn:
Have you encountered a suspicious charge on an insurance claim? Share your story with us—your experience could help others avoid falling victim to similar scams!
To read more, find source article here