Prevent and denounce fraud

Prévenir et dénoncer la fraude

What is insurance fraud?

Fraud is any deliberate action that enables individual insureds or suppliers to obtain a reimbursement of expenses to which they are not entitled.

The consequences of fraud


Higher premiums

Group insurance premiums are calculated based on group consumption, among other things. When benefits are paid following the submission of inappropriate claims, the premiums may be increased.


Reduced coverage

If the group insurance plan costs increase, the policyholder could decide to decrease or withdraw certain services.


Health risks

The administration of unnecessary care represents a health risk. Moreover, false treatments burden a patient’s file needlessly. They could also compound the difficulty associated with underwriting a private insurance plan (particularly for life and disability insurance).



If fraud is demonstrated, the employer may apply sanctions against the employee, to the extent of suspension or dismissal.

How to protect yourself?

How to protect yourself


Protect your personal and confidential information.


Review your claim history online regularly.


Store your plan documents (booklet and service card) in a secure location.


If you have any questions concerning a supplier, contact La Capitale.


Check your receipts to ensure that all the treatment items indicated were indeed administered.


Do not sign any claim forms in advance, and report any supplier who asks you to do so.

How to report a suspicious situation

If you witness or know of a suspicious situation, contact us. 

1 800 463-4856

Email us