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Aviva Investigation Uncovers Insurance Scam

It’s no secret that Ontario residents pay the highest auto insurance rates in the country; 45% more than Albertans and more than double that of drivers in the Maritimes, according to the Insurance Bureau of Canada (IBC). Industry estimates indicate that 15-20% of the rates are directly attributable to auto insurance fraud.  On a $1,800 annual premium that translates into a $270-$360 per year out of pocket expense due to deceit.

Although the auto insurance industry allocates significant resources to fraud prevention, detection and reduction, the active participation of consumers, healthcare professionals and other industry partners is vital to reducing fraudulent claims.  The disclosure to Aviva Canada by a client who felt pressured to lie about injuries sustained in an accident illustrates the pervasive nature of insurance fraud and the need for invested parties to work together to defeat it.

Aviva Anti-Fraud Team Captures Compelling Evidence

Upon receipt of the client’s allegation, Aviva’s anti-fraud team launched an undercover investigation that resulted in compelling video evidence and invoices to Aviva for as many as 50 treatments that were never received.  CTV News, in its article Undercover investigation captures alleged car insurance fraud, notes that although none of the allegations have been proven in court, the video does appear to show two employees of the Wellness Centres of Ontario and a Toronto paralegal encouraging and coaching the undercover investigators to misrepresent their claims.

The video footage also shows the paralegal from Kovtman Law (located near Wellness Centres of Ontario) explaining in great detail, how both the paralegal and the investigator can illegally obtain insurance payouts. The investigator was told he would get a $10,000 insurance settlement in approximately one year; $3,000 to be retained by the law office and $7,000 for the investigator. (Source: CNW a PR Newswire.  Read the full article, Aviva Canada surveillance video and investigation lead to charges against Toronto legal and health care professionals)

Chiropractor, Paralegal and Receptionist Charged with Fraud

Toronto Police Service commenced investigation Project Duffy, based on the evidence provided by Aviva Canada. According to Detective Constable Chris Briggs of 32 Division Fraud section,

“This type of fraud is common, but seldom do insurance companies come to the police with information that could lead to an arrest and charges.”

As a result of the combined efforts, Dr. Edward Hayes, 57, of Vaughan, and Doina Osacenco, 59, of Toronto, have each been charged with three counts of fraud and paralegal Anna Kovtanuka, 31, of Thornhill, is facing two counts of fraud and possession of property obtained by crime charges.