In a decisive move to protect the integrity of the insurance industry, Ontario’s insurance adjuster regulator, the Financial Services Regulatory Authority (FSRA), has banned an ex-insurance adjuster from conducting any further insurance business in the province. Additionally, the regulator imposed a hefty fine of $100,000 on Ulrich Fabrice Avognon, who orchestrated a fraudulent scheme to defraud an Ontario insurer of more than $220,000 in 2023. This significant action serves as a warning to others within the insurance industry about the severe consequences of dishonest practices.
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Details of the Fraudulent Scheme
Ulrich Fabrice Avognon, a licensed insurance adjuster with two separate license numbers under Manitoba’s Insurance Act, engaged in a series of fraudulent activities while working as an adjuster in Ontario under a temporary letter of authority from the FSRA. This letter allowed Avognon to carry out preliminary duties on Ontario insurance claims as he worked towards obtaining an official Ontario adjuster license.
In February 2023, Avognon began entering fraudulent charges into the insurance claim system of an Ontario insurer. These charges included fabricated costs for towing, car storage, and rental car services that were never actually required by the insured individuals. To further deceive the system, Avognon entered false invoice numbers and created fictional payees, using his own personal bank account information for payments.
Over the course of approximately three months, between February 9 and May 25, 2023, Avognon executed 99 fraudulent payments, totaling $221,543.02, directly transferring the funds to bank accounts under his control. These illicit transactions were disguised as legitimate insurance claims for towing, car storage, and rental car services, services that the insured parties never received.
Dual Employment and the Discovery of the Fraud
While working for Adjuster Company 1 in Manitoba, which provided claims adjusting services for Ontario insureds involved in automobile accidents, Avognon was also employed by a second adjusting firm, Adjuster Company 2. This dual employment, which was not disclosed to either company, led to Avognon’s termination from Adjuster Company 1 on July 19, 2023, after Adjuster Company 2 informed the company of his unauthorized dual employment.
Following his termination, Adjuster Company 1 discovered the fraudulent activity and reported it to the FSRA. The company also took the responsible step of reimbursing the Ontario insurer $250,115 to compensate for the fraudulent claim payments made by Avognon.
FSRA’s Response and Final Order
In light of Avognon’s deceptive actions, the FSRA issued a final order on February 13, 2025, permanently banning him from engaging in any insurance-related business in Ontario. The FSRA also imposed a significant $100,000 fine for his breach of Ontario’s Unfair or Deceptive Acts or Practices Rule. This penalty underscores the regulator’s commitment to maintaining trust and fairness within Ontario’s insurance market.
The FSRA also noted that Avognon’s actions violated several core principles of the insurance profession, including honesty, integrity, and accountability. The fine and ban reflect the severity of these violations and serve as a reminder to all insurance professionals about the importance of upholding the highest ethical standards.
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Broader Implications for the Insurance Industry
The case of Ulrich Fabrice Avognon is a stark example of how fraudulent activities can undermine the insurance industry and put consumers at risk. While the financial loss in this instance was significant, the actions taken by the FSRA to hold Avognon accountable demonstrate the province’s dedication to ensuring the integrity of its insurance system. By issuing a permanent ban and a sizable fine, the FSRA is sending a clear message that fraud and deception will not be tolerated in the insurance sector.
Additionally, Adjuster Company 1’s swift action in discovering and reporting the fraudulent activities helped mitigate the damage, showcasing the importance of vigilance and ethical conduct within the insurance industry.
This case serves as a cautionary tale for other insurance professionals, reinforcing the need to operate with transparency and integrity. The FSRA’s ruling reinforces the ongoing efforts to ensure that Ontario’s insurance market remains fair and secure for both consumers and businesses alike.
For those in the insurance industry, Avognon’s fraudulent actions serve as a reminder of the devastating impact dishonesty can have on the reputation and financial stability of insurers. As this case progresses, it is likely to prompt further discussions about tightening regulations and improving the safeguards in place to prevent such frauds from occurring in the future.
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