Former adjuster disciplined for $13K insurance fraud scheme

A former Beneva claims adjuster has had her licence temporarily suspended for a year, after she tried to pass off her clients’ claims information as her own to bilk more than $13,000 from her own insurer, Belair.

Nathania Kalyn has not held an adjuster’s licence since December 2022, about four months after events led to her pleading guilty to multiple violations of the province’s Code of Ethics for Claims Adjusters. She has since taken a loan from her mother to pay back the money to Belair, and then paid her mother back in installments.

“In Laval and Saint-Placide, between or around May 27, 2022 and August 9, 2022…[Kalyn] acted against the honor and the dignity of the profession of claims adjuster by falsely declaring to [her] insurer that the photos and documents transmitted in connection with a gazebo were linked to [her own] claim, while these photos and documents, some of which were falsified, came from the claim file…of the victims, R.P. and J.P., for which [she] was the responsible claims adjuster,” the Chambre de l’assurance de dommage ruled in a decision last month.

“Essentially, these documents made it possible to establish that [Kalyn] had extorted from the Bélair insurance company a sum of $13,245.54 by falsifying various documents from two other insureds (R.P. and J.P.) in order to make it appear that it was [her] own loss and thus claiming compensation.”

Beneva dismissed Kalyn once the insurer was informed of the situation.

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When contemplating Kalyn’s sanction, the Chambre identified a number of mitigating factors, including her youth and her relative inexperience as an adjuster at the time of her ethical violations. She was 36 years old and had only three years of experience in the claims adjusting field at the time of the incident, and without a disciplinary history prior to then, the Chambre noted in its decision.

Also, Kalyn admitted guilt and made full restitution to Belair, paying back the entire amount of $13,245.54.

She has not practiced as an adjuster since then, having not applied to get her adjuster’s licence reinstated, the Chambre decision notes.

Should she ever have her license reinstated, she must wait for a year before she can practice once again as an adjuster.

Feature image courtesy of iStock.com/Olivier Le Moal

David Gambrill