Canadian Life & Health Insurance Facts // 2024 Edition 17
Working together to tackle fraud and
keep health benefits affordable
Every year in Canada, health benefits fraud costs employers and insurers
hundreds of millions. False claims, fraudulent charges for non-covered
services, plus the costs insurers bear for investigations add up. That's why
insurers have started working together through the CLHIA on initiatives
to reduce benefits fraud and help to keep plans affordable. These
initiatives enhance insurers' own programs and are producing results.
Reached over 12 million Canadians
through a multi-year education campaign
aimed at recognizing benefits fraud.
Analyzed data from over 55 million claims
using advanced artificial intelligence to
identify links to potential fraud.
Implemented three new industry
wide tools to mitigate benefits
fraud – a central registry of
providers, a pool of deidentified
claims data, and a facility for
investigations across companies.
Health Insurance
L I N E S O F B U S I N E S S
