Rehabilitation Clinics and Clinic Owners and Directors Face 15 Charges Related to Submitting False Invoices to Insurers for Payment

TORONTO, May 25, 2012 /CNW/ - The Financial Services Commission of Ontario (FSCO) has charged five rehabilitation clinics and 10 individuals affiliated with these clinics with offences under Ontario's Insurance Act.

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 or services provided to an insured and engaging in an unfair or deceptive act or practice:

• Professional Medexam Management Inc. (2414 Major MacKenzie Drive, Maple ON)
• Assessment Direct Inc. (2888 Bathurst St., Toronto ON)
• Century Diagnostics Inc. (37 Kodiak Crescent, Toronto ON)
• Evident Diagnostics Inc. (160 East Beaver Creek, Richmond Hill ON)
• Supermed Rehabilitation Centre Inc. (7777 Kipling Avenue, Woodbridge ON)

The following individuals, affiliated with a clinic as a director, were also charged with one count each of failing to take reasonable care to prevent the corporation from making false statements to an insurer and from engaging in an unfair or deceptive act or practice:

• Mark Zinger
• Yan Krivoruk
• Alex Smolar
• Paul Benchetrit
• Pavlo Tsysar
• Ivan Terziev
• Vladimir Naidenov
• Alla Pechenik
• Eugene Gurevich
• Valeri Znamenski

On May 24, 2012, these individuals and corporations were summonsed to appear in the Ontario Court of Justice.

FSCO investigates allegations of misconduct, unfair practices and non-compliance with legislation or regulations in its regulated sectors. If warranted, FSCO takes enforcement action, such as initiating a prosecution. 

FSCO is an agency of the Ministry of Finance established under the Financial Services Commission of Ontario Act, 1997. It regulates insurance, pension plans, loan and trust companies, credit unions and caisses populaires, co-operative corporations and mortgage brokerages and administrators in Ontario. 

QUOTES

• "Manipulation and fraud in health care clinics increase auto insurance premiums for all Ontario drivers.  FSCO is committed to investigating, prosecuting and rooting out these abuses." - Philip Howell, CEO and Superintendent of FSCO.

QUICK FACTS 

• Ontario's Auto Insurance Anti-Fraud Task Force released an interim report in December 2011; it is expected to release a final report by fall 2012, including recommendations on the regulation of health clinics, the establishment of a dedicated fraud unit, and a consumer education and engagement strategy.
• As part of its work with the Task Force, FSCO is leading a working group that is investigating how the Health Claims for Auto Insurance (HCAI) system could be used to detect and prevent fraud. Health care facilities and providers are required to use HCAI to transmit auto insurance claims forms to insurers.
• Through the illegal use of health practitioners' names or other identifiable information, fraudsters seek to obtain payment from insurers for health care services that were never provided.

LEARN MORE 

• Go to Fighting Auto Insurance Fraud: What You Can Do about detecting and reporting fraud in the auto insurance system.
• Read about insurers' rights and responsibilities to challenge questionable or abusive claims.
• Learn how health care practitioners can protect themselves from identify theft.
• Find out more about FSCO's enforcement activities.
• Read the Interim Report of the Auto Insurance Anti-Fraud Task Force.

Kristen Rose
416-226-7803
[email protected]

Public inquiries:
1-800-668-0128