Five arrested for sanctioning false medical claims using forged documents

June 16, 2016 12:00 am | Updated October 18, 2016 01:16 pm IST - NEW DELHI:

The police claim to have busted a gang of cheats allegedly involved in sanctioning false medical claims for corporate employees.

The five men arrested include the alleged mastermind Vishal Gupta and an employee of the company.

The case came to light after an employee of M/s Vipul Med Cap, TPA Pvt. Ltd. situated in Bhikaji Cama Place filed a complaint alleging that the company had been cheated of Rs. 56 lakh on the basis of false medical claims.

“An enquiry found that 33 medical claims were bogus and that Rs. 28,17,320 was encashed fraudulently. Later, two more complaints were received about fake medical claims wherein bills of around Rs. 30 lakh were cleared. We registered a case of cheating and forgery based on the complaint,” said Deputy Commissioner of Police (South) Ishwar Singh.

The police probe found that employees who had “claimed” insurance were not even aware of it.

“Vishal Gupta, with help from Ganesh and Deepak, would procure the employees’ medical card, copy of cheque and ID proof from Dr. Pankaj Bhardwaj, who is head of the company’s Claim Processing Division. Nikunj and Ganesh would send mails to collect details of the employees’ medical claim card,” said Mr. Singh. He added that Ganesh would get the medical claims cleared and transfer the amount to Deepak and Amit Kumar’s accounts.

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