DOHA: In a rare incident, a company has reportedly zeroed in on a secret network involving its staff misusing the health insurance system for their financial gains.
The network included representative of a big company who reportedly tied up with the agent of a private health service provider and a group of expatriate employees of the company. The modus operandi was to conduct fake medical tests and surgeries on the company’s employees, Al Sharq reports.
All the three parties involved in the fraud were found making financial gains out of the secret deal, said the daily.
The fraud was unveiled during investigations conducted by the company in collaboration with the authorities concerned.
The company officials grew suspicious of the foul play when they noticed an unusual increase in the monthly health insurance cost of the labourers and other staff employed by the company. He also discovered that a big number of workers had undergone expensive surgeries and medical tests within a short period.
The manager soon started a secret investigation with the help of the authorities concerned to find out the reasons. They found that at the end of every working day groups of employees were being taken in a car to a health service provider to complete their transactions apparently for treatment and examinations that they have never undergone. The workers were also being given a share of the dividends from the deal.
The company representative as well as the workers in the network were Asians, said the daily.
The health service provider was found making huge profits by misusing the health insurance system within the budget allocated for each employee, said the daily.
There have been frequent complaints about doctors and health facilities exploiting health insurance cover to conduct unnecessary medical tests for their patients. However, this is the first time a secret network of this sort has reportedly been found misusing the health insurance scheme through fake medical tests and surgeries.
The authorities concerned have taken action against the people involved in the fraud, said the daily.
The National Health Insurance Company (NHIC) managing the National Health Insurance Scheme (Seha) is currently providing insurance cover to the citizens while the expatriates are covered by private insurance providers.
The Peninsula
