Dubai plans crackdown on fraudulent medical claims

Patients being kept in hospital longer to boost insurance claims, says top healthcare official

(Photo for illustrative purposes only)

(Photo for illustrative purposes only)

Dubai is looking to crackdown on fraudulent medical claims where private hospitals overcharge for medication or patients are "over-diagnosed" and kept in hospital longer in order to boost the bill sent to insurance operators, it has been reported.

“Sometimes people are kept longer than necessary in a hospital or an intensive-care unit. These kinds of things are daily issues that insurance members face and they need to be protected," Dr Haider Saeed al Yousuf, director of the Dubai Health Authority, was quoted as saying a report by The Telegraph newspaper.

He also added that a scheme was being set up to investigate the practice by private hospitals.

It is mandatory for employers to give medical insurance to employees as part of their contract of employment, but consultants said some institutions use this as an opportunity to overcharge insurance providers.

In some cases this includes minor offences like prescribing unwanted medication or ordering expensive but unnecessary procedures, such as MRI scans.

Insurance firm InterGlobal, which has offices in the UK, Asia and across the Gulf, has highlighted this issue and said it picked up on fraudulent claims every day.

"A lot of insurers were caught out. We got on to the case and were only very lightly affected," Paul Weigall, InterGlobal's sales and marketing director, was quoted as saying.

"We are very active on the fraud investigation front. We encourage our customers, our hospitals and everyone else involved to report to us if they feel something is not correct.”

InterGlobal played a key role in uncovering one lucrative fraud where bogus claims where being submitted to insurance firms over a ten year period for a virtual hospital and non-existent consultants.

"You'll find a group of people who have built up a fabricated health care system, which will include hospitals, doctors and customers – making it very difficult for an insurer not to pay out on a claim that's submitted. Then we find that nothing of that actually exists,” Weigall said, referring to the scam as the "telephone in the desert" case.

"However, there are also hospitals that overcharge. For example, you need 20 aspirin, they charge you for 200," he added.

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Posted by: txcnguy

If you need quality medical attention you must find it elsewhere, typically your home country. Don't even bother, boycott all of them.
It doesn't exist in Dubai. Also false advertising is rampant, drive down JBR and stop in any clinic and ask where the expat doctor advertised on the front is.

Posted by: Sal

Tell me what is not a business in UAE especially Dubai. Dubai is more materialistic than most of the Western countries. There are no enough law to protect the customers in any case, be it health, education or real estate. Shame on you Dubai.

Posted by: Government hospital worker

Its not just Dubai but Abu Dhabi too. Here the private hospitals bleed the card dry and then refer to government hospital for further care - which then has to be given free or the patient pays out of their our pocket. Sometimes investogations have to be repeated as the private hospital will not release the results but most times the tests were unnessary.

Posted by: Oldtimer

I'm a physician who moved to govt. health sector from private bcoz of unethical practices there. Recently I took my wife to a Pvt. hospital where the staff wanted to know if she had insurance even before asking what her illness was! I did not reveal my profession on purpose; later even before any vital signs etc were recorded after opening a file, she was asked to sign a paper with a list of investigations. I then lost my cool & asked how the doctor came to the decision which tests to order without even seeing the patient! In another case recently, my nephew who had a fall and got a one cm cut wound on the forehead was admitted and a plastic surgeon sutured the cut under General Anesthesia! Such cuts are sutured in govt. ER under local anesthesia in under 10 minutes and sent home! 3 day stay, operation room and specialist charges for no reason! The private health system in Dubai is mostly corrupt.

Posted by: david

Its normal in Arabs countries, the have money,oil , and building, but most of sanitaries and Dr. are form otheres countries,

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