If you didn't submit to insurance yet? Don't

TheKWguy · May 26, 2018

Had a guy msg me on another forum, remember the reddit guy? It's related to that, you won't believe what happened

So he asked me for advice.... apparently sunlife is asking him for proof and details for last claim! He's got to take a picture of something or provide other 'collaborating' evidence. They are going to look at all his other submissions as well going back 2 years! They are questioning him on all his RMT, naturopath, chiropracter and other type of expenses.

If you bought a package or were planning to submit shit for bascially a bodyrub. don't hold off right now

Leviathan · May 26, 2018

Advise him to start looking for a new job and he may get blacklisted by insurance companies ?

TheKWguy · May 26, 2018

They are going after the provider of the receipt right now it looks like. They want the details, he has 5 business days to resubmitt with collaborating on the current expense and they will advise of the results of their investigation into the rest. They reminded him that he is responsible to keep all documentation related to his claims.

TheKWguy · May 26, 2018

anyways I passed it on, it's not a warning re any specific area. Everyone is an adult, your responsible for your own dick and circumstances.

Hangdai · May 26, 2018

As long as you have a official receipt with RMT reg#, date services were rendered, there is absolutely nothing that can happen to the customer.

Most plans require you to either submit the original receipt, or a scan of it online.

Steeper · May 26, 2018

Steeper · May 26, 2018

City of Toronto has fired over 200 employees for benefit fraud more to come

Jumpin’ Jack Flash · May 26, 2018

Keep them separate guys!
I just use up my RMT claims for actual RMT massages.

Pinkblossom · May 26, 2018

Be aware that even if you have a rmt receipt, depending on the plan, they may require you to see a physician to verify the need. Particularly if the insurance company suspects fraud.

GTA-Traveller · May 26, 2018

The issue usually involves a shared RMT licence. Many places all use the same shared licence. Eventually the insurance company looks at the data. e.i. One RMT provider has done 16 massage in 1 day everyday for 3 months.

Red flags and you caught.

Hangdai · May 26, 2018

GTA-Traveller said:
The issue usually involves a shared RMT licence. Many places all use the same shared licence. Eventually the insurance company looks at the data. e.i. One RMT provider has done 16 massage in 1 day everyday for 3 months.

Red flags and you caught.

You mean the RMT is caught.

This is all available to see in various professional Association websites.
RMT is disciplined a few months to admitting to letting others at their workplace use their name and reg# for customers they didn’t do.
Many are disciplined for not keeping good records.
The only time RMT’s are disciplined for inappropriate professional conduct, is when insurance companies send in private investigators.
Like I said, if YOU have received an official receipt from a business, all is good on your end.

If I submit an official receipt, which I’ve actually paid for, I get reimbursed because I received a service for which I’m entitled too, period.

What do you think will happen, insurance companies use spy satellites to see through the walls to determine you are getting a handjob in the last 5 minutes, come on!

They are after the big fraud schemes where guys are claiming therapy for imaginary accidents, or kick backs on glasses and orthotics.

krayjee · May 26, 2018

Health Hub and Yi ren were well known for selling RMT receipts for 35 bucks without giving any massage while Eratim was working there. Don't know about now and the license is still valid or not.

littlealiens123 · May 26, 2018

Can you share what spa he was making the claim for?

TheKWguy · May 26, 2018

Wont say. I still respect PM code. He only said that I can say its Sunlife looking. They are only investigating him and the receipt/licensing person that provided the slip.

They did not ask where he got the slip from, they imply that they are aware he was likely NOT at those places on the days he submitted claim for.

Hiker · May 26, 2018

Hangdai said:
You mean the RMT is caught.

This is all available to see in various professional Association websites.
RMT is disciplined a few months to admitting to letting others at their workplace use their name and reg# for customers they didn’t do.
Many are disciplined for not keeping good records.
The only time RMT’s are disciplined for inappropriate professional conduct, is when insurance companies send in private investigators.
Like I said, if YOU have received an official receipt from a business, all is good on your end.

If I submit an official receipt, which I’ve actually paid for, I get reimbursed because I received a service for which I’m entitled too, period.

What do you think will happen, insurance companies use spy satellites to see through the walls to determine you are getting a handjob in the last 5 minutes, come on!

They are after the big fraud schemes where guys are claiming therapy for imaginary accidents, or kick backs on glasses and orthotics.

As Hangdai mentioned the employee is fine. The insurance company will issue a notice to all members of the plan that any claims from a specific masseuse from a specific date will not be accepted. If you use the masseuse and submit a claim after that date, then it will not be paid.

TheKWguy · May 26, 2018

Hiker said:
As Hangdai mentioned the employee is fine. The insurance company will issue a notice to all members of the plan that any claims from a specific masseuse from a specific date will not be accepted. If you use the masseuse and submit a claim after that date, then it will not be paid.

Normally ok yes. Just not worth the hassle and scrutiny. If you were reporting alot of shit, you might be boned and have to repay. Or they could report to employer, that's probably worst case.

The one that is really free and clear is the massage parlour. no one goes after them.

TheKWguy · May 27, 2018

I won't say even if it's via PM. if you paid for a rub and tug. Suck it up and eat the bill.

If your thinking of trying to buy a package or some kind of "rmt" claim for a bill to help defray your hobby pricing...THEN LOL...hold off for now or don't claim to sunlife.

Leviathan · May 27, 2018

The insurance and any large company will run predictive analytics (sophisticated algorithms software) on all the claims data and identify fraud patterns, correlations as well as anomalies that trigger red flags to either investigate or monitor until warranting a investigation. Anyone who is claiming mpa expenses from a sketchy shop is risking termination not only from insurance but employment. They prioritize their investigation by dollar size of the fraud risk.

TheKWguy · May 27, 2018

Leviathan said:
The insurance companies run predictive analytics on all the claims data and identify patterns, correlations as well as anomalies that trigger red flags to either investigate or monitor until warranting a investigation. Anyone who is claiming mpa expenses from a sketchy shop is risking termination not only from insurance but employment.

can you translate that to english. Big words like Hippopotamus make my head hurt

Leviathan · May 27, 2018

Sure don’t make insurance claims with sketchy mpa shops as you will eventually get caught. CRA, telcos, credit card firms and big banks all use the same Predictive analytics software.

TheKWguy said:
can you translate that to english. Big words like Hippopotamus make my head hurt

If you didn't submit to insurance yet? Don't

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