Stop fraud and unethical behaviour in its tracks

Preventing fraud

We’ve got some advice to share on how to sharpen your reflexes to better protect yourself against fraud and unethical behaviour.

Not today scammer, not today.

There are many types of scams so you should always stay vigilant and protect yourself. Do any of these scenarios ring a bell?

You receive an email, text or call

asking you to provide personal information

You notice unfamiliar claims

on your benefit statement

You get a new insurance contract

for insurance you never requested

You scheme with a health professional

to get insurance receipts for services not provided

You’re promised unrealistically high returns

on investments for reasons unknown

Think you’re a victim of fraud or maybe witnessed it?

Report fraud

Report the situation immediately. We’ll take it from there and do all the necessary checks.

What is fraud and how to recognize it?

Unethical behaviour and fraud come in many different forms. Fraud is an illegal act that’s intentionally carried out to deceive, hide or misrepresent, often to get an advantage, avoid a loss or cause harm to someone else.

Unethical behaviour doesn’t respect an organization or profession’s rules or codes. It can also go against accepted moral standards. Does any of this sound familiar?

Faking an accident

Willfully damaging your own vehicle and then claiming it was an accident.

Care not received

Falsifying or producing fake insurance receipts.

Exaggerating damage

Claiming for things you don’t own or exaggerating actual damage.

Care not provided

Submitting a claim for care that a health professional never provided.

Collusion

Plotting to claim for care not received and sharing the reimbursement amount.

Voluntary omission

Hiding previous claims, the age or wear and tear of an asset at the time of underwriting.

Faking dependents

Adding ineligible dependents to your group insurance contract.

Lying about your health

Hiding relevant medical information about your health to get insurance.

Lying about your finances

Earning income without reporting it to the insurer to continue receiving benefits.

Have you witnessed fraud? Get in touch with us right away.

Report fraud

Our tips to protect you Stay on your toes

One of the biggest misconceptions about fraud is thinking it won’t ever happen to you.

The truth is that it can happen to anyone. You have a pivotal role to play in preventing fraud and unethical behaviour. Adopting these simple and effective practices is a good start.

  • Only do business with health professionals who are members of their order or association.
  • Check your claims history.
  • Protect your personal information and never send it to someone you don’t know.
  • Keep your insurance card in a safe place.
  • Before visiting a health professional, head to the Client Centre to see the list of ineligible associations, institutions and health professionals.
  • Refuse to sign a claim form in advance and report a health professional who pressures you to do so.
  • Call us in the event of a car accident. We’ll recommend certified garages and towing companies.
  • If you get an offer that seems too good to be true, it could be fraud! Be vigilant and ask questions!

Identity theft

  • Never send your personal information to anyone (social insurance number (SIN), PIN, account number, etc.)
  • Always use our Customer Service to get in touch with us.
  • Never allow remote access to your devices to install updates, antivirus and other required systems.
  • Never accept incoming calls asking for personal or confidential information.
  • Never send money to an external source without checking to make sure it’s a real person or organization.
  • Consider changing your passwords on a regular basis, especially your email.

Phishing

  • Verify the sender’s email address and domain name.
  • Never download or open a suspicious attachment.
  • Don’t open a link in an email if you’re unsure where it came from.
  • Be cautious on public computers and Wi-Fi networks as they can be hacked. Don’t view financial or personal information there.

Our actions to fight fraud

Each year, our teams actively work to prevent, detect and investigate suspected cases of fraud. Here are some procedures and tools they have in place to get the job done:

  • Secure and anonymous procedure to report your suspicions.
  • Dedicated investigation teams with multi-disciplinary skills.
  • Technological tools using data analysis and artificial intelligence (AI).
  • Rigorous process to recognize professional associations.
  • Trusted partners who share certain data and expertise to fight fraud.

More questions about fraud? We’ve got answers.

Fraud has consequences for everyone from plan members to the groups who rely on us when using the services of health professionals we choose to collaborate with.

By working to prevent fraud, we can limit hikes in your group insurance as well as your home and car coverage rates. We’re all in this together.

Being accused of fraud is serious. You could:

  • Lose your right to compensation
  • Lose access to your group insurance
  • Lose your job (in group insurance)
  • Face legal proceedings

A false claim happens, for example, when a plan member makes a false statement to get more compensation after a loss. A plan member could even fake a theft or accident to get compensation.

To start, log in to the Client Centre.

On beneva.ca

  • Access your account.
  • Go to the Group insurance section.
  • See or download the List of excluded health professionals.

On the mobile app

  • Access your account.
  • Tap Group benefits section and then More online services.
  • See or download the List of excluded health professionals.

To learn more

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