Protecting your Plan

Employers are fully aware of the rising costs of providing employee benefits. It is critical to appreciate the extent to which fraudulent conduct on the part of patients and healthcare providers contributes to rising premiums.

What RWAM does to protect your plan

The insurance industry devotes significant resources to reducing benefits fraud. Sophisticated programs for identifying patterns of fraudulent behaviour are continually developed to limit costs and increase the chances of recovery.

To ensure we are only paying for legitimate claims covered under your employee benefits contract RWAM:

• conducts provider and patient audits
• investigates suspicious claims or patterns
• checks credentials of paramedical providers to ensure legitimacy

How you can help protect your plan

As a plan member, you also have a role in helping to prevent fraud. To learn more about your role in fraud prevention visit the Plan Members Protecting Your Plan page.

Report Fraud

If you are aware of or suspect insurance fraud, contact the RWAM Special Investigations Unit: 

• by email  special.investigations@rwam.com
• by phone 1-888-742-7926 ext. 4807

Fraud can also be reported to insurers via the Canadian Life and Health Insurance Association website.