The investigation has reportedly uncovered over $5 million in fraudulent claims
The Toronto Transit Commission (TTC) and police authorities have filed charges against ten current and former TTC employees in relation to an alleged multi-million-dollar benefits scam.
The charges were the first filed as a result of a years-long probe, which the TTC said has already resulted in 150 TTC employees being fired, being retired, or leaving the agency, according to the Toronto Star.
“This is public money and people will be held to account,” TTC spokesperson Brad Ross told the Star. “We want to bring an end to this.”
Nine out of the 10 people charged have left the commission; the tenth is still employed there, but is currently on medical leave. Each of the suspects faces one count of fraud amounting to more $5,000.
Since 2014, the police and the TTC have been investigating allegations involving Healthy Fit, a local orthotics store in Toronto. Owner Adam Smith and employee Savatah Nget reportedly “counselled and conspired” with TTC workers who claimed $5 million worth of benefits from Manulife, the TTC’s insurance provider.
The store reportedly “provided some or no products that were invoiced,” after which TTC workers gave it a cut of the insurance payments they received.
The police are also accusing Healthy Fit of running a similar scheme with Toronto city employees, which produced some $96,000 in claims.
Smith and Nget are both being charged with fraud over $5,000 and conspiracy to commit an indictable offense. Smith also faces charges of laundering the proceeds of a crime.
The agency believes the scheme dates back to at least 2012, but it was only in 2014 that the commission got a tip via its integrity line.
Ross said the TTC has been “very open and transparent with the public on this and we will continue to be,” adding that it will seek “restitution” from any other employee who submitted inflated or bogus claims.
Manulife is also taking steps to ensure that fraud does not become a recurring issue. “Manulife takes fraudulent insurance claims seriously,” a Manulife spokesperson told Life and Health Professional.
“We continue to invest in technologies that support the detection of irregular activity and that make fraud easier to identify and investigate. Early detection and prevention of fraud ultimately leads to cost savings for plan sponsors and an enhanced customer experience for plan members.”
For more of Wealth Professional's latest industry news, click here.
Related stories:
Artificial Intelligence the next frontier for fighting healthcare fraud
Insurance scam hits TTC
The charges were the first filed as a result of a years-long probe, which the TTC said has already resulted in 150 TTC employees being fired, being retired, or leaving the agency, according to the Toronto Star.
“This is public money and people will be held to account,” TTC spokesperson Brad Ross told the Star. “We want to bring an end to this.”
Nine out of the 10 people charged have left the commission; the tenth is still employed there, but is currently on medical leave. Each of the suspects faces one count of fraud amounting to more $5,000.
Since 2014, the police and the TTC have been investigating allegations involving Healthy Fit, a local orthotics store in Toronto. Owner Adam Smith and employee Savatah Nget reportedly “counselled and conspired” with TTC workers who claimed $5 million worth of benefits from Manulife, the TTC’s insurance provider.
The store reportedly “provided some or no products that were invoiced,” after which TTC workers gave it a cut of the insurance payments they received.
The police are also accusing Healthy Fit of running a similar scheme with Toronto city employees, which produced some $96,000 in claims.
Smith and Nget are both being charged with fraud over $5,000 and conspiracy to commit an indictable offense. Smith also faces charges of laundering the proceeds of a crime.
The agency believes the scheme dates back to at least 2012, but it was only in 2014 that the commission got a tip via its integrity line.
Ross said the TTC has been “very open and transparent with the public on this and we will continue to be,” adding that it will seek “restitution” from any other employee who submitted inflated or bogus claims.
Manulife is also taking steps to ensure that fraud does not become a recurring issue. “Manulife takes fraudulent insurance claims seriously,” a Manulife spokesperson told Life and Health Professional.
“We continue to invest in technologies that support the detection of irregular activity and that make fraud easier to identify and investigate. Early detection and prevention of fraud ultimately leads to cost savings for plan sponsors and an enhanced customer experience for plan members.”
For more of Wealth Professional's latest industry news, click here.
Related stories:
Artificial Intelligence the next frontier for fighting healthcare fraud
Insurance scam hits TTC
