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Thu 26 Nov 2009 07:40 AM

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Daman gets tough on healthcare fraudsters

Insurer plans to double size of investigating team after recovering $1.6m in false claims.

Daman, the UAE’s largest insurer, has toughened up its policy on fraudulent claims and has so far recovered more than $1.6m from clinics, it was reported on Thursday.

“We have zero tolerance for this,” said the company’s chairman, Khaled al Qubaisi, in comments published by UAE daily The National.

He told the paper anyone caught breaking the rules would be prosecuted, adding that the company plans to double the number of staff in its medical investigations unit.

More than half of the money reclaimed over the past 11 months came from a single dental practice, which investigators found had been submitting fake claims, he added.

The insurer, which was created in September 2005 and now handles up to 700,000 claims each month, has the authority to pursue civil cases against healthcare providers suspected of committing fraud.

“This year we have recovered AED6 million. This was from 91 cases we opened and investigated. Our aim is to stop fraud and abuse altogether. It is similar to stealing,” Qubaisi said.

Daman said it would also pass a file to the Health Authority-Abu Dhabi, which has the power to investigate further and suspend or revoke licences if it deems it necessary.

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