Four held for health insurance scam in Noida

Four people, including the alleged mastermind of a pan-NCR health insurance fraud valued at more than 2 crore, were arrested Tuesday morning from Noida.

The Lucknow unit of the UP Special Task Force (UP-STF) recovered 18 ATM cards, multiple sets of fake identity cards, 11 cellphones, fake SIM cards, two laptops, printers, 96 seals of various doctors, hospitals and pathology labs, cheque books, fake hospital bills, 4,500 letter heads of various hospitals, 21 claim forms, 35 hospital registration forms, two cars and 3,485 in cash from the suspects.

According to STF officials, the suspects allegedly duped insurance companies of more than 2 crore using at least 500 fake insurance claims. The suspects were identified as Amit Tyagi, native of Meerut, Ankur Tyagi , native of Ghaziabad, Harsh Mishra and Saurabh Bhandari, natives of Gautam Budh Nagar.

“They would prepare fake documents of people with bank accounts for the fraud. They were arrested around 5.30am from Sector 21,” assistant superintendent of police, STF (Lucknow), Vishal Vikram said.

The STF said they had been receiving complaints of fake health insurance for some time now. “A cyber team had been working on this. We got to know that a case was registered in Noida’s Sector 58 police station in 2019 by the senior manager of an insurance firm alleging that multiple claims have been taken by the beneficiary of the same bank account. An investigation revealed that cheques for this account were being signed by different people. Meanwhile, similar cases were being registered across Delhi,” Vikram said.

Interrogation revealed that Amit had worked for a health care company as an executive in 2014-15. “There he met another executive who helped him get a false claim of 42,000 and who suggested that by paying a commission of 30% receiving more such claims was possible. This gave him the idea of leaving his job and starting such a practice in 2016,” the ASP said.

Amit allegedly started taking help from doctors of private hospitals to make fake bills and used their connections to rope in other doctors for more fake bills, the police said.

“They would buy health insurance data from private vendors and sometimes sell fake health insurance. After a few days, they would show fake medical emergencies using hospital letter heads and then file these claims. In case, there was an investigation by the insurance firm, they would bribe the investigating officer with a 10% commission. They would give 30% commission to the doctors helping them and the claim beneficiary. Rest would be divided amongst the gang members,” said the ASP.

Amit has also allegedly used these funds to start his own hospital in Hapur. Police officials said the suspects were being helped by several doctors, investigators, hospital heads, insurance claimers etc. Action will be taken against them all once police has enough evidence, said the ASP. The suspects were later handed over to the Sector 58 police and booked under sections of cheating and forgery.

Source: Hindustan Times