KOCHI: The police have launched a detailed probe into a medical insurance fraud case in which an employee of a major private hospital in the city allegedly siphoned off lakhs of rupees after forging insurance records of patients.
Based on the complaint lodged by the hospital, a case has been registered against four persons including a senior staff identified as Shiny P P, 47, of Ikkaranadu North who used to work in the insurance wing of the hospital. The police said the incident came to light after hospital authorities lodged a private complaint before a local court and secured a favourable verdict to conduct a detailed probe.
The police said Shiny was working as a senior manager at the insurance department of the hospital and had allegedly committed fraud to the tune of Rs 15 lakh between December 1, 2011 and October 14, 2020. The accused forged documents and misappropriated the amount collected from the patients as advance payment for the insurance claim despite claiming the amount from the insurance company.
Though she was supposed to transfer the advance amount as refund to the patients after claiming the amount, she failed to transfer the amount to the patients. The accused transferred the money she allegedly misappropriated by committing fraud in three tranches. Initially, she transferred Rs 5.24 lakh to her aunt’s account, then Rs 3.61 lakh was transferred to her son’s account and again Rs 6.39 lakh to another account. The police said the accused could access the list of patients with insurance coverage as it was her duty to prepare the list of patients eligible for insurance claim.