The Background

The life and health insurance industry is a pillar of the financial services market in Canada, providing Canadians and their loved ones with security and access to healthcare when they need it most.

A key player in that space, the Canadian Life and Health Insurance Association ("CLHIA") is a not-for-profit, membership-based organization representing 99% of Canada's life and health insurance companies. CLHIA represents members on a wide range of strategic objectives, including promoting public policies that contribute to the betterment of the Canadian economy and society.

Health and dental benefits fraud is a burgeoning issue in Canada, with private insurers estimating hundreds of millions of dollars are stolen annually. While more "traditional" activities remain rampant (e.g.: inflating the size of a claim/transferring unused benefits), the industry is now reckoning with a more sophisticated brand of fraud, including organized crime rings and deep-seated collusion between medical service providers and employees.