EMPLOYMENT BENEFITS INSURANCE FRAUD
Employment Benefits Insurance Fraud
Employees often receive a benefits plan through their employer for health care services such as dental, massage therapy, physiotherapy, optometry, and orthopedics. Issues arise, however, when employees are investigated by the insurance company for unsubstantiated claims.
It may come to your attention that you are being audited or investigated by an insurance company in a number of ways. For example, you may be informed by one of your health practitioners that they have received inquiries about your claims for paramedical, dental, and other services. You may also be contacted by an Investigator from an insurance company by phone, email or in person about your claims. You could also be brought into a HR meeting by your employer and asked to explain the claims in question.
Internal Insurance Company Investigations
Insurance companies often investigate matters of unsubstantiated claims internally. These investigations often commence by way of routine claims audits. The insurance company may contact you requesting additional information or supporting documentation for a number of claims that you previously made. It is important to contact a lawyer early on in this investigation process. A lawyer will provide you with important legal advice before you speak to an insurance investigator or your employer about any health benefits claims issues.
Employment Consequences
Allegations of insurance benefits fraud can have a significant impact on your livelihood, your career, and your family. An allegation of insurance benefits fraud could result in being charged with criminal offences, being terminated from your employment, or being sued by the insurance company. Criminal penalties can result in a criminal record, which can further impact your future career prospects.
Criminal Penalties or Civil Lawsuit for Insurance Fraud
An insurance company or your employer could also commence a civil lawsuit against you for fraud and may seek the recovery of any funds that were lost.
An insurance company can also forward their investigation to police, who may decide to lay charges for fraud. (Link to Fraud Over $5000 page) A conviction arising from insurance fraud charges can also result in a number of penalties, depending on your previous criminal record. If you have previously been involved in fraud, the chances of incarceration increase. If you have no prior convictions or a compelling personal circumstance, a conviction could result in a lesser fine or other penalty.
Contact a Toronto Insurance Fraud defence Lawyer
To arrange a free initial consultation with Damien R. Frost & Associates, call 416-923-1900 or contact the legal defence firm via email today.
Areas of Practice
- Health Care Professionals
- Audiologist Defence
- Chiropractor Defence
- Dental Hygienist Defence
- Naturopathic Doctor and Naturopath Defence
- Occupational Therapist Defence
- Optician Defence
- Optometrists Defence
- Pharmacist Defence Lawyers
- Physiotherapist Defence
- Private Health Care Clinics
- Registered Massage Therapists Defence
- Nurse Defence Lawyer
- Registered Psychotherapist Defence
- Traditional Chinese Medicine Practitioners and Acupuncturist Defence
- Professional Licensing and Discipline
- Health Professions Appeal and Review Board
- White Collar Criminal Defence
- Insurance Fraud
- Appeals and Judicial Review
- Regulatory Offences and Defending Corporate Clients
- Legal Consulting Services
Office Location
Damien Frost & Associates LLP
1073 Bloor Street West, Suite 1
Toronto, ON M6H 1M6
Phone: 416-923-1900
Fax: (866) 235-6191
Members of The Criminal Lawyers Association, Toronto Lawyers Association, Ontario Bar Association
and Advocates' Society.
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REVIEWS
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"I have been very pleased working with Rebecca. She worked very efficiently, professionally and cared for every step, as we went through the process with Ontario College of Pharmacists. Initially I thought I would be going through a nightmare when I received my paperwork from Ontario College of Pharmacists, but Rebecca made the process seamless and the outcome was positive. Thank-you Rebecca and I would highly recommend your excellent professional service to others."
NP
Very Professional and Helpful
"I hired Ms Rebecca Young regarding a legal matter in October 2015. I found her and the firm to be very professional and helpful. The whole process took about one year to resolve. I followed her advice and the outcome was in my favour. I would recommend her for her professionalism, knowledge and pleasant attitude."
I.S.
Excellent Advocacy. Pleased with the Outcome!
"Daniel, Thank you for your excellent work. I am pleased with the outcome. I didn’t feel ‘prosecuted’ and I believe that is due to your excellent advocacy skills and rapport with the Court."
AF
Very Pleased with Mr. Frost’s Representation
"We were very pleased with Mr. Frost’s representation. He provided us with the best possible legal representation. He was dedicated to obtaining a tremendous resolution in what was complex litigation while being always mindful that we required a cost-effective solution."
BB
Nothing Short of Remarkable!
"I was very grateful to have the knowledge, experience and support of Rebecca Young when I was presented with a legal issue concerning my private practice. She ensured that my own professionalism and experience were demonstrated while representing me in communication with the CRPO. In addition, she offered recommendations to improve my due diligence measures, thereby further protecting my business and reputation going forward. Thank you Rebecca."
MM
Truly Professional, Confident & Trustworthy
"I was very happy with how Damien Frost handled my case and with what they accomplished for me. From my very first call with Rebecca, she gained my confidence and trust. She was very knowledgeable and she handled herself with true professionalism. She took the time to explain to me the process as well as her strategies so I always knew what was going on. She was always an email or a phone call away and she resolved my case to my full satisfaction."
SG
Incredibly Supportive & Experienced
"I had an extremely positive experience working with Rebecca Young. She is so pleasant to deal with and not only provided sound counsel right from the first day but continued doing so in a manner that was clear and compassionate. Incredibly supportive and experienced team. I was kept up to date at every step and got an amazing outcome in a very short time. Highly recommend working with Rebecca!"
GB
Instantly Put Me At Ease
Rebecca was very helpful in my particular situation. I spoke to a few lawyers before her and I can't tell you how good she was. She instantly put me at ease by telling me what I was dealing with - others had scared me a lot. She was almost my therapist whereby I would get in touch with her, send my thoughts, and get responses on what the process looked like - she was straightforward, compassionate and understanding of the situation. Great service and no fear-mongering at this company. Thank you for all your help, Rebecca!
DL
Damien Frost & Associates LLP
1073 Bloor Street West,
Suite 1, Toronto, ON M6H 1M6
Phone: 416-923-1900
Toll Free Number: 1-800-329-3951
Fax: 1-866-235-6191
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