Health insurance companies, combined with general and life insurance companies in India, have collectively lost about Rs 30,401 crore as a result of fraudulent claims during 2011. This was reported by businesstoday.intoday.in.
A study carried out by Pune-based company Indiaforensic stated that various frauds that took place in the life, non-life and health insurance segments, totaled a loss of about 9 per cent of the estimated size of the entire insurance industry.
AdvertisementHealth insurance clients, said the report, defrauded insurance companies by not disclosing existing diseases. Such customers manipulated empanelled doctors at the stage of application. They also submitted false age certificates so that they could become eligible for health insurance.
The most common type of fraud was forging of medical bills. 31 per cent of fraudulent claims settlements used forged medical bills. Clients sometimes travelled abroad for surgery, but did not disclose it.
According to the Insurance Regulatory and Development Authority (IRDA), the total annual premium income of the insurance industry is around Rs 3.5 lakh crore.