Thursday, 23 February 2012

Insurance News - Thursday, February 23, 2012

'Project Whiplash' Leads to Early Morning Arrests

More than three dozen people are in custody Thursday following multiple arrests across the Greater Toronto Area overnight which targeted a vehicle insurance fraud ring.

The investigation, code named "Project Whiplash" concentrated on an accident and insurance fraud ring allegedly run by members of the Tamil community. The 37 suspects arrested in Scarborough, Brampton and Markham face 130 charges.

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Toronto Police Services news release on Project Whiplash.

FSCO Lays Charges Against Rehabilitation Clinics

The Financial Services Commission of Ontario (FSCO) has charged four rehabilitation clinics and six individuals affiliated with these clinics with offences under Ontario’s Insurance Act. These clinics and individuals are alleged to have submitted false invoices to insurers as part of a staged auto accident ring.
On February 23, 2012, the following clinics were charged with one count each of knowingly making false or misleading statements to an auto insurer to obtain payment for goods and services provided to an insured and engaging in an unfair or deceptive act or practice:
  • McCowan Rehabilitation Clinic (1583 Ellesmere Road, Suite 104, Scarborough, Ontario)
  • Ontario Rehabilitation Clinic (3031 Markham Road, Suite 31, Scarborough, Ontario)
  • Physiotherapy Clinic (1920 Ellesmere Road, Suite 110, Scarborough, Ontario)
  • North York Health & Rehabilitation Centre (1280 Finch Avenue West, Suite 519, Toronto, Ontario)

FSCO Arbitrator Recognizes 60-Day Timeline for Mediations

A recent decision by FSCO Arbitrator Jeffrey Rogers supports that a mediation can be deemed to have failed if it has not been mediated within the 60 day timeframe noted in both the Insurance Act as well as The Dispute Resolution Practice Code.

In the decision, Leone and State Farm, Arbitrator Rogers states the following:

There is no merit to State Farm’s submission that the Application is not filed until a mediator is appointed. The definition of “file” does not suggest that interpretation. The Insurance Act and the Rules themselves treat filing and appointing a mediator as separate events. Section 280(2) of the Act sets the requirement for filing the application. Section 280(3) then requires the Director to “ensure that a mediator is appointed promptly.” Rule 13.1 states that on “receipt of a completed Application for Mediation… a mediator will be appointed promptly.” The Commission recognized this separation when it advised Mr. Leone that “[C]omplete applications are taking longer to be assigned to a mediator as a result of the large volume of applications which we continue to receive.

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