Former general insurance sales person, Martin Hroch has been fined by the Insurance Council of British Columbia (ICoBC) and will not be able to renew his application for any insurance license in the province for five years, after he admitted he made 76 false claims for physiotherapy services and vision care over a 13 month period.
All told, Hroch received $3,045 from the insurer responsible for the agency’s employee health and wellness program as a result of his fraudulent claims.
Amounts claimed in each instance varied from $25 to $75, resulting in an overpayment of $2,570 for physiotherapy services. In addition to the 74 false physiotherapy claims, the former agent also admitted to having submitted two fraudulent vision claims for which he received $475.
Although the insurance company agreed to a repayment plan, Hroch then failed to pay back the funds, despite a revision to the plan which occurred to accommodate the former agent. Ultimately Hroch ceased making payments altogether after having repaid the insurer only $425.
“Council concluded, based on the seriousness of the former licensee’s misconduct that the former licensee is unsuitable to hold a license,” the insurance council writes in its order reviewing the case. They say although the value of each claim was small, the sheer volume of illegitimate claims demonstrates that he had established “a pattern of routine and egregious disregard” for the standards of trustworthiness and good faith. “The former licensee’s failure to reimburse the insurer in accordance with the terms of the payment plan agreement was considered by council to be an aggravating factor that further called his trustworthiness and good faith into question,” they add.
In addition to a five-year suspension of his license, Hroch is also fined $5,000 and has been assessed the insurance council’s investigative costs of $1,875.
