Healthcare fraud, let’s beat it together
Healthcare fraud increases premiums for our customers and we do our very best to eliminate it
There may only be a relatively small number of individuals or providers who engage in medical insurance related fraud, but maladministration, including innocent and careless overcharging for treatments and services, also raises the cost of medical insurance.
Fraud is the dishonest intent to obtain a financial gain from, or cause a financial loss to, a person or party through false representation, failing to disclose information or abuse of position.
Fraud is a crime
Examples of fraud include:
- giving false or misleading information in order to obtain insurance or a reduction in premium;
- deliberately failing to disclose previous medical history when required;
- claiming for treatments or services not received;
- using somebody else’s insurance to obtain treatments or services;
- altering or amending invoices or any other documents;
- claiming from more than one insurer for the same treatment or service; and
- falsifying diagnosis.
Examples of maladministration include:
- duplicate billing;
- incorrect billing for treatments or services;
- providing unnecessary treatments or services.
Here are some simple steps you can take to help protect yourself and keep premiums down:
- Compare invoices with your records. Check the dates are correct and the treatment or services were actually provided to you.
- Ask questions if you do not understand, or if there are any discrepancies.
- Liaise closely with us in the event of a claim.
- Contact us if you are concerned that your medical practitioner is providing treatment that is not necessary for you.
- Carefully complete any Claim forms. If there is anything you do not understand or are unsure of, please ask us.
- Look after your insurance details and documentation.
- Make sure you understand any documentation before you sign.
- Keep copies of any documentation and correspondence.
- Report suspected fraud to us.
We are committed to protecting you against fraud and also have statutory responsibilities to prevent our products from being used as a vehicle for financial crime.
We operate strict controls to deter, prevent, detect and investigate fraud.
We work closely with others to prevent fraud
We work in conjunction with other insurance providers and the following organisations to prevent and detect fraud:
- Health Insurance Counter Fraud Group (HICFG);
- International Insurance bodies;
- International Police and Investigative agencies; and
- Governmental departments.
Contact us if you suspect fraud
If you suspect fraud or have any information relating to fraudulent activity, please contact our Fraud and Investigation Team:
Confidentail telephone line: +44 (0) 1252 745 990 (ext 5990)
Fraud and Investigation referrals: email@example.com
InterGlobal are proactive members of the Health Insurance Counter Fraud Group (HICFG) and part of the board steering group which helps set the group’s strategy and direction.
Go to HICFG
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