An industry body set up by private medical insurance (PMI) providers is to meet next month as it steps up its efforts to address the issue of healthcare fraud.
The Health Insurance Counter Fraud Group plans to meet formally for the first time in November to discuss the issue, which insurers claim costs them millions of pounds each year.
As revealed by Health Insurance Magazine in May, the group has developed a new web-based intelligence system which will include a database of dubious practices carried out by doctors and hospitals but also of fraudulent customers, fraudulent insurance brokers and fraudulent employees.
A website has also been developed containing information about the group and its work as well as telephone number for reporting the public to report suspected frauds and an anonymous and confidential basis if they wish.
Acting as spokesman for the group, Dr Simon Peck, head of provider information and audit at AXA PPP, the UK's second largest PMI provider, said: "For too long companies have worked in isolation and when a fraud is discovered by one company it simply shifts to another. The mission of our group is to pool our resources and knowledge to drive the fraudsters out of our industry."
In addition to PMI providers, the Health Insurance Counter Fraud Group also includes non-member attendees from the City of London Police, the Association of British Insurers and the NHS Counter-Fraud Service.
The initiative is also being "strongly supported" by the Association of British Insurers. Next year, healthcare fraud experts from partner organisations in the US, Canada, South Africa, Australia and Europe will be invited to an international symposium with the aim of taking the best practices from around the world and implementing them in the UK.
Credit: Article Taken from Health Insurance Magazine: October 2008 Full Article: http://www.hi-mag.com/
Editors Note: Many within the broker community welcome this approach to managing fraudulent claims. Like with all classes of insurance, fraudulent claims add unwanted costs to a claim which must ultimately be reconciled somewhere down the line, inevitably adding cost to already spiraling premiums. However, there is also a huge loss from insurers in the UK today based largely on inefficiency and in some cases in competency. We would welcome the industry addressing this problem which is likely to cost the industry more than the 5% estimated by fraud.
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