Former Definity adjuster disciplined for $102K embezzlement scheme

Quebec’s P&C insurance regulator has found a former insurance adjuster guilty of an embezzlement scheme, in which he faked client claims and siphoned more than $100,000 in claims payments from Definity into his own bank accounts.

The Chambre de l’assurance de dommages (ChAD) says the former Definity adjuster, Tresor Luyeye, committed 13 Code of Conduct violations and is no longer practicing as an adjuster, nor does he have a licence to do so.

“[The] evidence clearly demonstrates that the [former adjuster] repeatedly used a fraudulent scheme to embezzle, on 13 different occasions, large sums of money for his sole benefit and/or that of his entourage,” says a ruling by ChAD’s disciplinary committee, released in late August [translated from French]. “The amounts embezzled represent an amount of more than $100,000. These are particularly serious offences, as recognized by the case law.”

Luyeye had been employed at Definity from December 2021 to March 2023, when “he abruptly left his job under unclear circumstances,” as ChAD’s disciplinary committee found.

“A few weeks later, his employer discovered certain suspicious bank transfers involving [Luyeye],” the ChAD decision reads. “It was then that [Mike Lake, investigator at Definity Insurance Group] began his investigation and noted several suspicious payments generated by [Luyeye].

“This investigation established that [Luyeye] was creating false claims for Definity clients and having the payment of these claims transferred to him by creating false email addresses.

“According to Definity’s internal investigation, [Luyeye] allegedly embezzled sums of money totalling $238,183.04.”

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Definity filed a civil lawsuit against Luyeye for the full $238,183.04 and “obtained a judgment that he is currently attempting to enforce,” as noted in the regulator’s decision. In the civil action, the court also ordered Luyeye to pay $25,000 in punitive damages, per ChAD’s discipline committee.

Definity also filed a complaint with ChAD, which zeroes in on 13 counts of professional misconduct against Luyeye. The counts before the regulator’s discipline committee focus solely on claims activity occurring between Dec. 6, 2022, and Feb. 16, 2023.

In each of the 13 counts, documents say the former adjuster had made a fake insurance claim to Definity on behalf of a client. He then created a bogus email account, where the insurer was directed to transfer the claims payments. Witnesses in the regulatory hearing included claims investigators from the National Bank of Canada, the Bank of Montreal and TD Bank.

The 13 false claims were for various amounts ranging between $455 and $21,750.59.

“Added to this is the testimony of each of the representatives of the various banking institutions demonstrating, beyond a shadow of a doubt, that all the embezzlement of funds was for and on behalf of [Luyeye], who, in doing so, illegally appropriated a total sum of $102,105.51,” reads the decision of ChAD’s disciplinary committee.

The regulator says Luyeye did not attend the hearing despite several attempts to ensure his participation. ChAD’s discipline committee found him guilty of all 13 counts by default and ordered that a new committee be struck to determine sentence.

 

Feature image courtesy of iStcok.com/masamasa3