Ontario’s insurance adjuster regulator has banned an ex-adjuster from doing insurance business in the province and fined him $100,000 for a scheme to defraud an Ontario insurer of more than $220,000 over the course of two months in 2023.
Ulrich Fabrice Avognon withdrew his request for a hearing on the proposed penalty, which now stands, effective Feb. 13. He was dually employed with two adjuster companies, and released when one of his employers learned of his dual employment.
The adjusting company that released him then found out about his fraudulent insurance scheme, and compensated the insurance firm $250,000 for the losses.
Avognon was a licenced insurance adjuster in Manitoba with two separate licence numbers (licence #2307133-R and #2307223-R) under Manitoba’s Insurance Act, according to the Notice of Proposal issued by the Financial Services Regulatory Authority, Ontario’s adjuster regulator, on July 12, 2024. He used a different address and birthday for each licence.
Avognon operated in Ontario under a letter of authority issued by FSRA effective from December 2022. The letter allowed Avognon to carry on preliminary duties on Ontario insurance claims while in the process of obtaining an Ontario adjuster licence.
Avognon was employed in Manitoba with an unnamed adjusting firm (called “Adjuster Company 1” in FSRA’s Notice of Proposal) to provide adjusting services for Ontario insureds who were involved in automobile accidents in Ontario, under licence #2307223-R.
While working with Adjuster Company 1, Avognon was also employed in Manitoba as an adjuster with Adjuster Company 2, under licence #2307133-R.
Upon learning he was employed at Adjuster Company 1, Adjuster Company 2 informed Adjuster Company 1 of Avognon’s dual employment. Adjuster Company 1 then terminated Avognon on July 19, 2023, due to the undisclosed employment with Adjuster Company 2. FSRA’s letter of authority allowing Avognon to work as an adjuster in Ontario was revoked at this time.
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About four months after letting Avognon go, Adjuster Company 1 issued a complaint to FSRA about a fraud scheme it had discovered after Avognon left the company.
With Adjuster Company 1, Avognon adjusted auto insurance claims submitted to an Ontario insurer, FSRA found. Avognon had authority to issue payments up to $25,000 on these claims.
“Starting in February 2023, Avognon began inputting charges in insurance claim files for towing and car storage, or for rental car services,” FSRA’s Notice of Proposal reads. “The towing and car storage, or rental car services were not required for the insured on these claims and the insured did not receive these services.
“Avognon input false invoice numbers into the system used to adjust claims and created false payees for the tow and storage companies, or rental car companies.
“For the false payees, Avognon input his own personal bank account information for accounts he opened at a bank or credit union. After inputting this information, Avognon issued electronic funds transfer payments to his own personal accounts for his personal use.
“Avognon made 99 fraudulent claim payments between Feb. 9, 2023, and May 25, 2023. In total, Avognon received $221,543.02 directly to bank accounts he controlled.”
Adjuster Company 1 reimbursed the Ontario insurer $250,115 for the fraudulent claim payments.
In its final order, issued last week, FSRA found Avognon had breached Ontario’s Unfair or Deceptive Acts or Practices Rule.
Canadian Underwriter has contacted the Insurance Council of Manitoba, which regulates adjusters in the province, to confirm Avognon’s licence status in Manitoba.
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