01 Mar The Impact of Benefits Fraud
Research tells us that 75% of Canadians believe that the only consequence of benefits fraud is increased premiums, or the possibility of being required to return the funds received.
Plan members believe that benefits fraud is a victimless crime, as they are simply ‘stealing’ money from profitable insurance companies, and not their own employer.
Not all benefits fraud is the result of actions from members, in many cases service providers are the instigator of the fraudulent activity.
Whether a member is the driver of the fraudulent claim, or it is their provider, benefits fraud is a criminal act that can lead to criminal fraud charges.
According to the Canadian Health Anti-Fraud Association, fraudulent claims cost the industry upwards of a staggering $6 Billion dollars ever year. While insurance providers all attempt to detect fraud, whether claims are submitted electronically or manually, it is clear that the magnitude of benefits fraud is not something that can be solved by providers alone.
It is a fact that benefits fraud results in everyone paying a higher cost for benefits.
As an employer offering a Group Benefits plan to your employees, what can you do?
- At JRP, we understand the importance of vigilance. Detecting concerning and possible fraudulent claiming patterns is part of every quarterly review that we prepare for our clients.
- It should be inconceivable to you, to only receive an annual renewal document from your broker – one that they themselves received from the insurance provider.
- It is extremely important that plan members understand the impact of benefits fraud within their Group Benefits plan, what it looks like and how to avoid it with service providers.
- When you work with JRP as your Benefits Advisor, we hold information sessions with members, and every session includes a discussion on fraud, as raising awareness about benefits fraud is an ongoing initiative at JRP.