Fraud Prevention Tips
To avoid being duped or allowing fraud without your knowledge, always be vigilant and keep your passwords to yourself. You risk your money by giving someone your access data to your insurer. Ms Frohlich mentions the case of a healthcare facility owner who convinced his clients to provide her with their access codes on the pretext of helping them verify their coverage to ensure that their claims would be accepted.
Once in possession of the customers’ passwords, he replaced their direct deposit data with his own and made false claims to receive money from their insurers.
To protect yourself, never do business with someone who asks for your passwords. Ms Frohlich also points out that fraudsters mainly target customers who have generous plans. So beware of retailers or service providers who ask questions like, “What else does your plan cover?”
Be on the lookout for other red flags:
Retailers try to trick you into buying more than your doctor has recommended. Be especially wary of abnormally enticing promotions, such as a free pair of shoes with the purchase of orthotics.
Avoid stores that sell more non-medical items than medical supplies. It is safer to buy medical supplies from specialists. For example, buy your glasses from the optometrist and your orthotics from the podiatrist.
Report Fraud: Call the Group Benefits Fraud Reporting Line
In addition to being very careful with your medical service providers, be aware of fraud within your organization. People often turn a blind eye to fraud to avoid being branded as whistleblowers or snitches on co-workers – and your silence can hurt you. “Here again, we come back to your group benefits plan. A fraudulent plan can become too expensive for the employer who will then have to reduce the benefits,” notes Ms Frohlich.
Many insurers, such as Sun Life Financial, provide you with a line reserved for the confidential reporting of fraud related to group benefits. If you are aware of fraud, the number to call at Sun Life Financial is 1-888-882-2221.
Conclusion
Criminals are constantly inventing new schemes to defraud group insurance. That’s why health benefit providers like Sun Life Financial are stepping up their efforts to counter them using the latest forensic fraud analysis technologies. If you have any concerns about your health benefits, let your employer or insurer know. By talking about it, you are protecting your health care coverage
