On March 1, the first day of Fraud Prevention Month 2023, the Canadian Life and Health Insurance Association launched a new initiative aimed at greatly improving the industry’s ability to investigate the misuse of benefits plan coverage.
The Joint Provider Fraud Investigation initiative will see all participating carriers, including Manulife, collaborate to conduct joint investigations into suspicious claims activities by providers.
“Rather than each impacted carrier performing their own independent investigations, the shared expertise and resources of all participating carriers can be called on to determine the appropriate next steps,” says Alanna Rand, Assistant Vice-president of Group Benefits Operations Integrity at Manulife.
“This is a really significant step forward for the industry, and for all plan sponsors and covered individuals regardless of which carrier provides their benefits plans,” says Rand. “And Manulife is thrilled to have been the very first carrier to initiate an investigation through the new program.”
This announcement builds on an industry program, announced in 2022, that uses Artificial Intelligence to help identify fraudulent activity across a vast pool of anonymized claims data. The Joint Provider Fraud Investigation program does not share personally identifiable information about plan members, and investigative evidence is held securely and can only be accessed by carriers who have joined the investigation.
