Woman Accused of Making Fraudulent Health Care Insurance Claims

A Windsor, Ont., woman has been charged with defrauding a Peterborough, Ont., insurance company of more than $20,000.

Peterborough police began an investigation in November 2014 after getting complaints about fraudulent claims made to the unnamed firm.

Officers allege the woman, who lived in Peterborough between 2011 and 2013, forged documents and made fraudulent health-care claims to her insurance provider totaling approximately $23,000.

Patrice Surette, 43, was arrested on June 6, 2016 and faces multiple charges including fraud over $5,000.

She appeared in Peterborough Provincial Court for a bail hearing and was released from custody, with another court appearance planned for June 16th.

 

Two brothers get 51 months in prison for $11-million tax fraud

KEITH FRASER

Two Vancouver-area brothers have been sentenced to 51 months in prison each after committing an $11-million tax fraud.

In December, following a three-week trial, B.C. Supreme Court Justice Elliott Myers found Fareed Mohammed Raza, 42, and Saheem Mohammed Raza, 35, each guilty of one count of fraud over $5,000.

As tax preparers, the brothers issued false donation receipts to 781 clients in the amount of $11 million in exchange for cash donations not passed on to a Bangladesh charity. The clients filed income tax returns in which they used the false donation receipts to claim deductions for which they were not entitled, to avoid paying $4.9 million in taxes.

The fraud occurred from December 2002 to June 2011. After the Canada Revenue Agency launched an investigation, most of the taxes avoided were collected from the clients.

In imposing sentence Tuesday, the judge noted he had found that the fraud was on an “industrial scale,” and spoke of the need to deter and denounce such crimes.

The prosecution argued that an aggravating factor was the number of victims, but the judge said he couldn’t say the clients were victims because they had to have known they were getting receipts for more than the actual donation, and he concluded: “The only true victim was the Crown.”

The defence argued that the culpability of the taxpayers ought to be a mitigating factor on sentencing for the brothers, but the judge rejected that submission.

“I cannot see that this has any effect on the accused’s moral culpability,” said the judge. “It is not a situation of the more the merrier. Put a different way, culpability is not a finite quantity that is to be divided between the number of the accused who participate in the scheme.”

The brothers had little reaction to the sentencing. Fareed Raza, who is married with one child, had immigrated to Canada from Fiji in 1997 and became a Canadian citizen in 2001. He had no prior criminal record.

The Crown had sought a sentence of five years in prison for the brothers while the defence argued for three to four years of jail. The offence carries a maximum penalty of 14 years in prison. The Crown asked for the brothers to be fined $570,000 each, but the judge declined to impose that penalty.

Faiz Khan, a nephew of the brothers, was convicted of attempted fraud under $5,000 but received a conditional discharge because the judge found that he had played only a minor role in the scheme.

Source: Vancouver Sun

Police probe of $1 million city hall “fraud” stretches into third year

By Matthew Van Dongen

No charges have been laid nearly three years into a police probe of an alleged $1 million fraud by a municipal accounts worker the city says admitted to theft.

The city announced Monday it had recovered through insurance most of the $1 million that went missing over nine years. But the state of the criminal probe appeared uncertain after police told the CBC last month there was no “active investigation.”

City finance director Mike Zegarac said Tuesday he wasn’t aware the police probe had stopped, adding he gave new information to investigators last week. Police spokesperson Catherine Martin also said Tuesday the investigation is “ongoing,” but didn’t say whether new information had resurrected the probe.

The city’s latest release refers to the financial loss as “mishandling of funds.” That’s a change in language compared to repeated use of the word “fraud” during a press conference in 2013. “The employee has admitted guilt and has admitted to the fraud and has admitted it was an act of the employee,” Zegarac said at the time.

He said then the alleged fraud, discovered during a facility review, involved rental payments from 51 businesses and customers as far back as 2005. Councillors said they were told the worker kept a journal of money juggled between accounts to avoid detection.

It’s not unusual for an insurance claim for fraud to be successful even without a criminal conviction, said Craig Brown, a Western University professor specializing in insurance law. “For a criminal charge, fraud has to be proved beyond a reasonable doubt,” he said. “For the purposes of insurance, it’s more likely determined on balance of probability.”

Taxpayers deserve more than a payback of public funds, argued Shane Coleman, a board member of the Hamilton Farmer’s Market. The city contacted vendors, some of whom paid rent in cash, asking for co-operation with the police probe in 2013.

“It’s a matter of public trust,” said Coleman, who has filed a formal request to see the city’s forensic accounting report. “It’s been three years and no one is charged; no one gets to see what happened. Are we just going to sweep it under the rug?”

Zegarac told The Spectator Tuesday the city believes no other employees were involved in the alleged fraud, but added the forensic report is confidential because it contains personal details about employees.

He said that report, combined with the city’s own internal audits, spurred “a series of changes” to city cash-handling like monthly reviews of financial reporting, new supervisory requirements for cash-handling staff, less reliance on use of cash and even cheque payments versus electronic transfers.

Source: Hamilton Spectator

Toronto: Man busted for alleged insurance scam

BY , TORONTO SUN

TORONTO – A Vaughan man has been accused of creating false identities to get insurance and then cashing in tens of thousands in bogus claims.

York Regional Police’s major fraud unit launched an investigation in October after receiving a call about a possible insurance scam, police said Monday.

Investigators alleged false identities and stolen credit cards were used to obtain and pay premiums on auto and home insurance policies. False claims were later made on those policies, according to police.

The insurance money paid out — around $63,000 in total — was funnelled into “fraudulent bank accounts” and then transferred to the suspect, police alleged.

Adeniyi Rafael Kayode, 36, is charged with fraud over $5,000, unauthorized use of credit card data, and laundering proceeds of crime. He is due to appear in a Newmarket courtroom May 5.

IBC Congratulates York Regional Police for charges in an alleged staged collision case

Toronto –  Insurance Bureau of Canada (IBC) congratulates York Regional Police on exposing an alleged staged collision scheme that has led to a total of 24 criminal charges being laid against four individuals. IBC’s Investigative Services division as well as member companies supported police investigators in this case.

By requiring police, ambulance and fire personnel to attend a collision scene, criminals who stage collisions for profit are wasting these limited resources, making them unavailable to respond to legitimate and potentially life threatening emergencies, and can even put the lives of emergency responders at risk.

“Staged collisions can draw innocent drivers into dangerous situations on the road,” saidGarry Robertson, National Director, Investigative Services, IBC. “Insurance crime adds unnecessary costs to our health care system, emergency services and courts, and it costs consumers in the form of higher insurance rates.”

Organized insurance fraud reduces road safety and drives up premiums for everyone. A single staged collision can result in more than $100,000 in fraudulent payouts. A government-commissioned report from KPMG for the Ontario Auto Insurance Anti-Fraud Task Force estimated that in 2010, the cost of insurance fraud ranged from $768 million to $1.56 billion dollars a year. This amounts to between $116 and $236 per average premium paid in Ontarioin any given year.

“Insurance crime is big business. When they cheat, we all pay,” continued Robertson. “IBC and police services rely on help from the community to catch fraudsters. That is why we always encourage people with information about insurance crime to report it online at ibc.ca, call our anonymous TIPS Line at 1-877-IBC-TIPS or call Crime Stoppers at 1-800-222-TIPS.

About Insurance Bureau of Canada

Insurance Bureau of Canada (IBC) is the national industry association representing Canada’sprivate home, auto and business insurers. Its member companies make up 90% of the property and casualty (P&C) insurance market in Canada. For more than 50 years, IBC has worked with governments across the country to help make affordable home, auto and business insurance available for all Canadians. IBC supports the vision of consumers and governments trusting, valuing and supporting the private P&C insurance industry. It champions key issues and helps educate consumers on how best to protect their homes, cars, businesses and properties.

P&C insurance touches the lives of nearly every Canadian and plays a critical role in keeping businesses safe and the Canadian economy strong. It employs more than 120,000 Canadians, pays $8.2 billion in taxes and has a total premium base of $49 billion.

For media releases and more information, visit IBC’s Media Centre at www.ibc.ca. If you have a question about home, auto or business insurance, contact IBC’s Consumer Information Centre at 1-844-2ask-IBC.

If you require more information, IBC spokespeople are available to discuss the details in this media release.

SOURCE Insurance Bureau of Canada

Court dismisses appeal in $65 million fraud case targeting B.C. seniors

By Camille Bains

THE CANADIAN PRESS

VANCOUVER _ British Columbia’s top court has refused to overturn the case of a former mutual funds salesman who defrauded hundreds of seniors by selling them $65 million in exempt securities.

David Michaels appealed a $17.5-million fine imposed by the B.C. Securities Commission, which found he illegally and fraudulently advised 484 people without being properly registered to sell securities.

The commission also ordered him to pay back the $5.8 million he earned in commissions and marketing fees for securities by advising seniors to sell their stocks, bonds and mutual funds to buy high-risk exempt market securities, which can be sold without filing a prospectus, and insurance-based investment products.

The B.C. Court of Appeal has upheld the commission’s findings of fraud and misrepresentation and the imposition of the fine in separate decisions for Michaels’ activities between 2007 and 2010.

Michaels promoted his business through 45-minute weekly infomercials titled “Creating Wealth with David Michaels” on a radio station in Victoria, saying he loved helping seniors make money.

However, the court says almost all the investments are now worthless and that many of Michaels’ clients have had their financial futures ruined.

“He told his listeners that the average age of his clients was 72,” the decision says, adding Michaels also held seminars in hotels and that his brochure described opportunities to earn an income without any stock market risk.

He also said clients could build their wealth by owning real estate, double their retirement savings every six years and have a guaranteed income that would last the rest of their lives.

In an August 2014 decision, the commission described Michaels’ actions as a textbook case of improper sales practices “that so violate the principle of investor protection and so seriously damage the integrity of our markets.

“Michaels preyed on clients by frightening them and misleading them into leaving the comparative safety of traditional capital markets for the far riskier part of the exempt market.”

The Vancouver Island man’s actions damaged the confidence of investors in both traditional and exempt markets because he portrayed himself as an experienced insider but operated on deceit, the commission said.

Spokesman Richard Gilhooley said Michaels has not paid the commission any of the $5.8 million he earned by bilking clients, nor has he paid the $17.5 million fine.

Gilhooley said the commission has the option of pursuing the money through B.C. Supreme Court but has not yet decided whether it will do so.

Investors would split any money the commission receives, he said.

canada-press

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