Ontario man arrested in $600K health care benefits scam

Peel Regional Police have arrested and charged a 30-year-old Vaughan, Ont., resident in connection to a series of health care benefits scams, which took place over a 22-month period.

Anand Pareshkumar Amin was arrested for what investigators from the Fraud Bureau are calling “health care benefits scams.” The criminal investigation concluded that the suspect scammed a health care benefits provider of more than $600,000 over the course of almost two years by submitting fraudulent scams, and sharing the profit with plan members.

“The victim, a health care benefits provider, paid out numerous benefit claims to multiple employees of a large online retailer,” said Peel Regional Police in a media release. “Some of these employees were working with the suspect to submit multiple fraudulent claims.”

Once the payout was dispersed by the health care benefits provider, the illegally obtained funds would then allegedly be shared between the individual plan member and the suspect. A Peel Regional Police spokesperson said to Yahoo Canada that the suspect was also an employee of the online retailer, but could not specify which one.

This fraudulent operation ultimately resulted in an initial loss of over $600,000 for the health care benefits provider. The Peel police spokesperson said that some of the money has been restituted.

Amin has been charged with fraud over $5,000. He was released with conditions and will appear at the Ontario Court of Justice in Brampton, Ont., on Sept. 25, 2023 in answer to the charge.

Officials are urging anyone with information regarding this investigation to contact the Peel Regional Police Fraud Bureau at 905-453-2121 ext. 3335. Tips can also be submitted anonymously to Crime Stoppers at 1-800-222-8477 (TIPS) or www.peelcrimestoppers.ca.

Health care benefits fraud: How to protect yourself

To ensure that you always protect yourself from the consequences of health care benefits fraud, learn how to properly use your benefits and how to properly recognize benefits scams.

Health care benefits fraud occurs when you intentionally submit false or misleading information to your insurance provider for the purpose of financial gain. It can be committed by health or dental service providers, plan members or both.

Peel Regional Police Officials have shared some tips that can help you prevent and identify benefits fraud:

• Protect your personal information, which includes your benefits plan username, password and other access information
• Never share your information for others to obtain products or services
• Check your receipts to ensure the accuracy of services or treatment received
• Never sign your name on blank forms
• Depending on your provider’s policy, keep a copy of the original receipt to support your claim
• Report any suspected abuse or fraud to your insurance company

If you suspect that your health care service provider, coworkers or others you know are encouraging you to submit a fraudulent claim, or something doesn’t feel right, report it to your employer or insurance provider.

Committing or participating in benefits fraud could result in serious consequences, such as losing your job, benefits and being charged with a crime.

Peel Regional Police is encouraging the community to learn more about these and other trends currently affecting Canadians by visiting the Canadian Anti-Fraud Centre and the Peel Regional Police Website.