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False medical claims are an easy way to make money for fraudsters. The ease of committing such acts, at least in India, has been luring more and more policy holders to make false claims. The false claim can be categorized under two categories. The first category is where there is no illness or medical problem and thus no expense has been made at all. This is very serious as the whole act of pretended illness is wrong and all the bills are fake. There are some notorious hospitals operating in India who connive with policy holders in making false claims. The bills of such hospitals require more scrutiny than that of others. As the claim is supported by bills and medical reports, it is not easy to refute such claims only on the basis of suspicion. Our experts will indicate if they are of the view that the claim is probably a false one along with their recommendations. A strategy is then formulated and detailed investigation is carried out to collect sufficient evidence to refute the claim. It is much easier to make and prove a false claim in medical insurance matters than doing so in the matters of life insurance. Thus, some people choose to make easy money in collusion with doctors or hospitals. We can investigate and verify the genuineness of the claim and we follow different strategy in handling cashless and Reimbursement claims.
The news of Insurance Fraud in India pop up regularly in media. The insurers are losing millions as a result of fraudulent claims and fraudsters have posed a serious threat to insurance industry. The fraudulent insurance claims are generally made by forming a strategy and are supported by fabricated documentary evidence such as fake death certificate, hospital bills, health reports and in some cases, even crime documents too. The beneficiaries also arrange for false witnesses in support of their claim. Under such circumstances, a basic investigation is not enough to expose the fraud and thus a detailed investigation needs to be carried out to verify the cause of death, place and time of death and other particular information. The organised gangs have emerged who have nexus with doctors, police officials, municipal office and village administrators. To fight with this menace, the insurers have either set-up their own fraud control units or have outsourced the said work to specialized agencies.
Our team of expert investigators is specialized in death claim verification in India and have the potential to smell the rat and expose the fraud. Their experience in the industry has enabled them to prudently differentiate fraudulent claims from the genuine claims. Analysis of minute details gives a clue as to the genuineness or fraud involved in a claim. The suspected documents and information are verified in a specialized manner which reveals the truth of the claim. During the claim investigations, the statements of third parties who are familiar with the death of the insured are also recorded and matched with that of the beneficiary. If their is any inconsistency between the statements, the same is investigated in detail. Once after completion of the investigation, a detailed report will be sent to our clients, containing all the relevant information.
The insurance holder can often think of claim fraud as being primarily perpetrated by organized fraud rings. An individual's can be motivated by any number of factors, including greed, lack of income and the feeling that they are not being dishonest by defrauding insurers. Our fraud detection efforts are sufficient for the detection of fraudulent environment.
Our ultimate goal is to help claim handlers to adhere a comprehensive investigative plan that is appropriate for every claim, balancing the risk of fraud and the practical cost of investigation.
We continuously strive to help you to provide a consistently high standard of service and understand the extensive enquiries related to the Insurance sector. We discuss all the issues in complete confidential manner which is also included non disclosure agreement where necessary.
Many times, it is observed that the hospitals that are empanelled are substandard and do not comply with the standards set forth by the TPAs. But still such hospitals are empanelled by the TPAs/ insurance company.
As part of empanelment process hospital need to provide the complete infrastructure details these details must be cross checked by TPA/ Insurance company, but due to time and other hurdles TPA/ Insurance companies are skipping this required process, to full fill this gap and to keep good quality hospitals in panel to give quality service , Clients can avail our services , which enable them to take quality hospital in to panel with reasonable tariff.
Also, there are instances where some hospitals are black listed by the TPAs for the frauds committed by them previously. However, these hospitals start their functioning anew with a different name and again apply to the TPAs / Insurance Companies for empanelment.
To keep a check on all these activities, we propose to have the HOSPITAL AUDIT. This will not only help to keep a check on such unscrupulous activities but in long run to improve the image and the quality of medical facilities provided in the city.
Our trained staff will personally visit the hospitals and thoroughly check each and every facility claimed by the hospital which includes its registration, nursing and laboratory staff with their qualification, infrastructure viz., number of floors, space, equipments, in-built facilities and also with hygiene.
We conduct background checks with extensive investigations which include a full background check from prior to the beginning of the employment to eliminate chances of hiring errors at the recruiting stage; these Pre Employment Verifications are conducted before the recruitment of a short listed job-applicant.
It helps to assemble the best team by picking up the right person for the right post. Therefore, it is important to verify the credentials of the employer before giving him the employment.
We offer a full package of employment screening services including Pre Employment Verification of credentials and references, checking of public records, and character evaluation. Each check will provide the most accurate and current information available, summarized and provided to our clients in an easy to read private investigation. These private detective services will provide pre-employment verification quickly and efficiently, as we understand that it is not practical to wait for a number of weeks to obtain the required information and fear the risk of losing a potentially valuable member of staff. We work with you to determine the information you need to make informed, responsible hiring decisions.
Employees are the backbone of any successful organisation. Promoting preventive healthcare can motivate employees to maintain their health, which could greatly improve company’s performance. Medical tests as part of their selection procedure. These tests are used to assess the fitness of the employee which can relate to both physical and mental attributes.
Truth Mining empanelled with many diagnostic centres in across Telangana and Andhra Pradesh to cater our corporate clients basic screening investigations to highly sophisticated medical examination needed to determine the candidate's medical fitness required as per the employment.
Pre employment health check up package includes basic screening tests which gives a comprehensive analysis of the candidate’s health and medical well-being. Usually, the pre employment medical exam package includes the following, but it varies for all companies.
Complete medical and physical examination. Laboratory tests and results which include- CBP, CUE, Rh factor, Chest X-Ray, Lipid profile, KFT, LFT, ECG, HIV, HBsAg (Hepatitis)
Consultations : Dental, ENT Non-Invasive Cardiac Risk Evaluation -Simple ECG, Cholesterol we receive the report directly from the labs. You will be informed if there is a major concern identified and that requires immediate attention for example like Hepatitis B. the medical reports will have details like,
It is vital that a pre-employment medical test relates exclusively and directly to the particular duties of the job and does not discriminate against people with disabilities. Employers could be liable for discrimination if they misuse Pre-employment medical tests.
One of the easiest ways to steal from a company is through expense reimbursements.
Fraud Schemes
The two primary schemes perpetrated are employees claiming reimbursement for fictitious expenses or inflating actual business expenses. Examples of fictitious expenses that have been known to appear on expense reports include:
Inflating business expenses can be found when employees
Life insurance is a promise between the policy owner and the insurer and it is a safeguard for family members, the insurer agrees to reimburse the occurrence of the insured person’s death or other event such as terminal illness or critical illness.
Companies within the insurance sector will be well aware of the statistics regarding fraudulent claims made by unscrupulous people. The cost to the insurance industry as a whole is rising each year causing losses beyond estimation. We firmly believe that all suspicious claims must be thoroughly verified and investigated by professional investigators. We act on behalf of many insurance companies investigating fraudulent and suspicious claim.
We are experienced in the investigation of life, health, personal accident including travel claims With our extensive investigation experience, we are able to provide professional investigative claims decision support to our clients.
We conduct extensive fraudulent Life insurance claim investigations and high standard of service and We discuss all the issues in complete confidential manner.
All above services are offered at cost effective prices and are highly guaranteed for accurate results and timely delivery. We are ready to serve you 24*7 Round the clock.
False medical claims are an easy way to make money for fraudsters. The ease of committing such acts, at least in India, has been luring more and more policy holders to make false claims. The false claim can be categorized under two categories. The first category is where there is no illness or medical problem and thus no expense has been made at all. This is very serious as the whole act of pretended illness is wrong and all the bills are fake. There are some notorious hospitals operating in India who connive with policy holders in making false claims. The bills of such hospitals require more scrutiny than that of others. As the claim is supported by bills and medical reports, it is not easy to refute such claims only on the basis of suspicion. Our experts will indicate if they are of the view that the claim is probably a false one along with their recommendations. A strategy is then formulated and detailed investigation is carried out to collect sufficient evidence to refute the claim. It is much easier to make and prove a false claim in medical insurance matters than doing so in the matters of life insurance. Thus, some people choose to make easy money in collusion with doctors or hospitals. We can investigate and verify the genuineness of the claim and we follow different strategy in handling cashless and Reimbursement claims.
The news of Insurance Fraud in India pop up regularly in media. The insurers are losing millions as a result of fraudulent claims and fraudsters have posed a serious threat to insurance industry. The fraudulent insurance claims are generally made by forming a strategy and are supported by fabricated documentary evidence such as fake death certificate, hospital bills, health reports and in some cases, even crime documents too. The beneficiaries also arrange for false witnesses in support of their claim. Under such circumstances, a basic investigation is not enough to expose the fraud and thus a detailed investigation needs to be carried out to verify the cause of death, place and time of death and other particular information. The organised gangs have emerged who have nexus with doctors, police officials, municipal office and village administrators. To fight with this menace, the insurers have either set-up their own fraud control units or have outsourced the said work to specialized agencies.
Our team of expert investigators is specialized in death claim verification in India and have the potential to smell the rat and expose the fraud. Their experience in the industry has enabled them to prudently differentiate fraudulent claims from the genuine claims. Analysis of minute details gives a clue as to the genuineness or fraud involved in a claim. The suspected documents and information are verified in a specialized manner which reveals the truth of the claim. During the claim investigations, the statements of third parties who are familiar with the death of the insured are also recorded and matched with that of the beneficiary. If their is any inconsistency between the statements, the same is investigated in detail. Once after completion of the investigation, a detailed report will be sent to our clients, containing all the relevant information.
The insurance holder can often think of claim fraud as being primarily perpetrated by organized fraud rings. An individual's can be motivated by any number of factors, including greed, lack of income and the feeling that they are not being dishonest by defrauding insurers. Our fraud detection efforts are sufficient for the detection of fraudulent environment.
Our ultimate goal is to help claim handlers to adhere a comprehensive investigative plan that is appropriate for every claim, balancing the risk of fraud and the practical cost of investigation.
We continuously strive to help you to provide a consistently high standard of service and understand the extensive enquiries related to the Insurance sector. We discuss all the issues in complete confidential manner which is also included non disclosure agreement where necessary.
Many times, it is observed that the hospitals that are empanelled are substandard and do not comply with the standards set forth by the TPAs. But still such hospitals are empanelled by the TPAs/ insurance company.
As part of empanelment process hospital need to provide the complete infrastructure details these details must be cross checked by TPA/ Insurance company, but due to time and other hurdles TPA/ Insurance companies are skipping this required process, to full fill this gap and to keep good quality hospitals in panel to give quality service , Clients can avail our services , which enable them to take quality hospital in to panel with reasonable tariff.
Also, there are instances where some hospitals are black listed by the TPAs for the frauds committed by them previously. However, these hospitals start their functioning anew with a different name and again apply to the TPAs / Insurance Companies for empanelment.
To keep a check on all these activities, we propose to have the HOSPITAL AUDIT. This will not only help to keep a check on such unscrupulous activities but in long run to improve the image and the quality of medical facilities provided in the city.
Our trained staff will personally visit the hospitals and thoroughly check each and every facility claimed by the hospital which includes its registration, nursing and laboratory staff with their qualification, infrastructure viz., number of floors, space, equipments, in-built facilities and also with hygiene.
We conduct background checks with extensive investigations which include a full background check from prior to the beginning of the employment to eliminate chances of hiring errors at the recruiting stage; these Pre Employment Verifications are conducted before the recruitment of a short listed job-applicant.
It helps to assemble the best team by picking up the right person for the right post. Therefore, it is important to verify the credentials of the employer before giving him the employment.
We offer a full package of employment screening services including Pre Employment Verification of credentials and references, checking of public records, and character evaluation. Each check will provide the most accurate and current information available, summarized and provided to our clients in an easy to read private investigation. These private detective services will provide pre-employment verification quickly and efficiently, as we understand that it is not practical to wait for a number of weeks to obtain the required information and fear the risk of losing a potentially valuable member of staff. We work with you to determine the information you need to make informed, responsible hiring decisions.
Employees are the backbone of any successful organisation. Promoting preventive healthcare can motivate employees to maintain their health, which could greatly improve company’s performance. Medical tests as part of their selection procedure. These tests are used to assess the fitness of the employee which can relate to both physical and mental attributes.
Truth Mining empanelled with many diagnostic centres in across Telangana and Andhra Pradesh to cater our corporate clients basic screening investigations to highly sophisticated medical examination needed to determine the candidate's medical fitness required as per the employment.
Pre employment health check up package includes basic screening tests which gives a comprehensive analysis of the candidate’s health and medical well-being. Usually, the pre employment medical exam package includes the following, but it varies for all companies.
Complete medical and physical examination. Laboratory tests and results which include- CBP, CUE, Rh factor, Chest X-Ray, Lipid profile, KFT, LFT, ECG, HIV, HBsAg (Hepatitis)
Consultations : Dental, ENT Non-Invasive Cardiac Risk Evaluation -Simple ECG, Cholesterol we receive the report directly from the labs. You will be informed if there is a major concern identified and that requires immediate attention for example like Hepatitis B. the medical reports will have details like,
It is vital that a pre-employment medical test relates exclusively and directly to the particular duties of the job and does not discriminate against people with disabilities. Employers could be liable for discrimination if they misuse Pre-employment medical tests.
One of the easiest ways to steal from a company is through expense reimbursements.
Fraud Schemes
The two primary schemes perpetrated are employees claiming reimbursement for fictitious expenses or inflating actual business expenses. Examples of fictitious expenses that have been known to appear on expense reports include:
Inflating business expenses can be found when employees
Life insurance is a promise between the policy owner and the insurer and it is a safeguard for family members, the insurer agrees to reimburse the occurrence of the insured person’s death or other event such as terminal illness or critical illness.
Companies within the insurance sector will be well aware of the statistics regarding fraudulent claims made by unscrupulous people. The cost to the insurance industry as a whole is rising each year causing losses beyond estimation. We firmly believe that all suspicious claims must be thoroughly verified and investigated by professional investigators. We act on behalf of many insurance companies investigating fraudulent and suspicious claim.
We are experienced in the investigation of life, health, personal accident including travel claims With our extensive investigation experience, we are able to provide professional investigative claims decision support to our clients.
We conduct extensive fraudulent Life insurance claim investigations and high standard of service and We discuss all the issues in complete confidential manner.
All above services are offered at cost effective prices and are highly guaranteed for accurate results and timely delivery. We are ready to serve you 24*7 Round the clock.