Benefit & Disability Fraud: The landscape, emerging trends and what group insurers can do to minimize the risk

Gary Askin
AVP, Fraud and Risk Management
Sun Life Financial Canada

Gary has been with Sun Life since September 2014 and has brought 33 years of experience from his former role as a Commander of Strategic and Tactical services with the Waterloo Regional Police Service-where he investigated and lead drug, organized crime, terrorism, gangs, intelligence, and hate crime teams and investigations.

As the Assistant Vice President Gary Askin provides strategic direction and day to day leadership to the Fraud Risk Management team.

Currently leading a team of 100 Sun Life fraud investigators and analysts using a dynamic and fluid intelligence led approach based on leading technology, experienced staff and innovative investigative techniques to prevent benefits fraud.

He is an expert in internal affairs, interviewing, drug and criminal investigations, hate crimes and terrorism, workplace harassment and violence investigations.

He was trained in Israel, Belgium, Germany, Italy and Canada in criminal organizations, terrorism, major events, protests, natural disaster and emergency management planning.

He is a published author and social media award winner.

Leila Campbell 
Anti-Fraud Program Administrator 
Canadian Life and Health Insurance Association 

Leila Campbell is the Anti-Fraud Program Administrator with the Canadian Life and Health Association (CLHIA). In her role, Leila supports the insurance industry by participating in industry committees, working groups and projects related to the mitigation of benefits fraud. 

Leila has over 20 years' experience in health and insurance administration. Prior to joining CLHIA, Leila held positions in Compliance, Life and Disability, and Investigations at Empire Life.  Leila graduated from the University of Ottawa with a BSC in Biology, has a certificate in Regulatory Compliance and has the Associate Life Management Institute designation. 

Leila has over 20 years' experience in health and insurance administration. Prior to joining CLHIA, Leila held positions in Compliance, Life and Disability, and Investigations at Empire Life.  Leila graduated from the University of Ottawa with a BSC in Biology, has a certificate in Regulatory Compliance and has the Associate Life Management Institute designation. 

Melissa Haig
Manager, Fraud Risk Management
Sun Life

As the Manager in Fraud Risk Management in Sun Life’s Group Benefits division, Melissa is responsible for investigating, detecting and preventing fraud through strategic direction and fraud risk management. Under her leadership, the team uses 

intelligence-led anti-fraud strategies to focus on the profiling of medical and dental providers and facilities, including the investigation into large collusion schemes and organized crime.

Melissa has been with Sun Life since 2001 and has worked in the investigation field within the insurance industry for the last 16 years, including participating in court and regulatory hearings pertaining to fraud.

Jon Sider, MBA
Director, Group Health and Dental Claims
Equitable Life of Canada

Jon is the Director of Group Health and Dental Claims at Equitable Life of Canada. He has been with Equitable Life for 20 years, gaining experience in a variety of roles across group benefits in areas such as life & disability, underwriting, product development, technology, benefits administration, health and dental claims, and fraud investigations. Each stop on Jon’s career journey has provided new learnings and the opportunity to work through challenges that have broadened his perspective on the group benefits industry.

Jon graduated from the University of Waterloo with a degree in Kinesiology, and later completed his Masters of Business Administration degree from Dalhousie University, specializing in Financial Services.

Kandrice (Kandy) Cantwell, CEBS,
CEBS-Compliant
Partner, Commercial Benefits
Westland Insurance Group / Montridge Advisory Group Ltd.

Ms. Cantwell is a Partner at Westland Insurance Group, which acquired Montridge Advisory Group in 2022. She began her career in the employee benefits field and held key positions with some of Canada’s largest insurers and consulting firms before joining Montridge in 2002.

With both a strong technical and marketing background in employee benefits, Ms. Cantwell consults some of Canada’s most dynamic employers, as well as numerous U.S.-based corporations for their Canadian benefits plan. Within Westland, her mandate is to help build Westland’s Commercial Benefits division through both current distribution channels and acquisition opportunities.

Ms. Cantwell serves on the ISCEBS Symposium Education Committee—Canada. She is a past Council member of CPBI-Pacific and is past President of the British Columbia chapter of ISCEBS. She earned her bachelor’s degree in business administration from Walla Walla University, earned her CEBS designation in 2012 and is CEBS-Compliant.

ATTEND TO LEARN:

- Define benefits fraud and identify its common types and indicators

- Understand the implications of benefits fraud for plan sponsors, members and providers

- Recognize the role and responsibility of all stakeholders in combating benefits fraud

- Apply the tools and resources available to help you protect your plan from benefits fraud

- How dental fraud happens (who’s and why’s)

- Understanding dental claims and codes

- What role does data analytics play in the dental fraud prevention and detection landscape

- Dental Fraud Risk Management – what you can do as a member OR as a plan sponsor

- Increase understanding of current technologies like artificial intelligence and their current commercial applications

- Build awareness of how these technologies are currently being used in the group benefits industry.

- Explore the potential risks these technologies may expose in the future.

- Provide insights into what the group benefits industry should be doing to prepare for these threats.