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Haryana STF busts insurance scam using dead cancer patients

April 20, 2019 05:38 AM

COURTESY TIMES OF INDIA APRIL 20

Haryana STF busts insurance scam using dead cancer patients
Manvir.Saini@timesgroup.com

Chandigarh:

The Haryana police’s special task force (STF) on Friday unearthed a scam in which insurance claims were made for deceased cancer patients by “proving” their deaths to have been caused by accidents.


The STF arrested Pawan Kumar Bhoria, a Sonipat-based advocate, described as the kingpin, and his associates, Mohit and Vikas, both from Gohana, for the racket. They have been booked under various sections of cheating, fraud, impersonation and forgery at Sonipat’s city police station.

The racket was unearthed in the first week of April after Bharti AXA Life Insurance moved a complaint about fraud insurance claims. “Since then, we had kept the three accused under surveillance. We tracked their movement and finally picked them up from Sonipat city on Friday morning,” DSP Rahul Dev, the supervising officer of the STF team probing this case, said.

The accused initially used to scout on their own for terminal cancer patients or those suffering from chronic diseases. Later they managed to regularly source details about these last stage cancer patients or those suffering from chronic diseases from PGIMS Rohtak or other referral hospitals.

Punjab bars release of vehicles involved in accidents without 3rd party insurance

Punjab won’t release vehicles involved in accidents that result in death or injuries unless they have third-party insurance cover or the owner furnishes “sufficient security”, enough to pay compensation to the victims, to the court. The state’s transport department notified on April 3 that vehicles will be auctioned in three months if either of these conditions are not met and the proceeds will go towards compensation P 3

‘They kept sources ready in hosps, police stations, PGIMS’

With these details, the gang used to get life insurance policies in their names from top firms like IFFCO Tokio, PNB Metlife, LIC, ICICI Lombard, HDFC Ergo, Edelweiss Tokio, Canara HSBC, Kotak Insurance, Max Life, Future Generali, Apollo Munich, Bajaj Allianz, and Aditya Birla Sunlife. At this stage, they managed to get these insurance policies without any medical records of the cancer patients being revealed to the insurance firm.

After the death of the patient, they used their sources in the police to register inquest proceedings for an accidental death.

At this point, their medical associates helped them get fake post-mortem reports giving reason of death as accident. Using these documents, the gang filed claims from the insurance firms and received between Rs 8 lakh and Rs 20 lakh, depending on circumstances of each case.

“Soon after the death of these patients, they kept their sources ready in civil hospitals, police stations and PGIMS. They would first get a complaint of accident lodged with help of cops involved in the racket and get a case registered. The gang would then get a fake post-mortem report and prepare a foolproof case for insurance claim,” Dev said.

The preliminary investigations have also revealed that the gang would get their sources to destroy the original medical records of the deceased in the hospital where they had been treated after registering a fake accident case. “Normally, they would target patients with throat cancer and would show neck injuries as cause of death,” said an official associated with the investigation.

The racket could run into several crores of rupees, DSP Dev said. “We think there could be at least 80-100 such cases of insurance and other fraud. We have laid hands on only eight cases so far. Preliminarily investigation and brief interrogation of the three accused has led to detection of more cases. We are studying the incriminating documents and diaries and (fake) policies recovered from the three accused,” added the DSP.

This is just the tip of the iceberg and many policemen, doctors, employees of PGIMS, Rohtak and other tertiary care hospitals and kin of the deceased patients could be involved in the racket and are under our scanner, Dev added.

“Let the investigation progress further, more names — of at least 12-15 professionals — are expected to be revealed,” the DSP said. “We will soon nab doctors, cops and others who helped the gang in this racket.

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