Insurance firms to sue corrupt hospitals

insurance-fraud


Insurance firms in the country claim they are losing money because hospitals and private practitioners are illegally inflating claims, and are planning to sue those found abusing the system.

The insurance companies allege they have been hit by claims from doctors for expensive laboratory tests and treatments for minor illnesses, a local publication reported.

The firms said they would institute tougher monitoring of hospitals and doctors starting in 2016, and would sue those found inflating costs, the report stated. They said they also plan to stop dealing with certain private hospitals, which have many complaints against them from patients who claim they have proof of fraudulent practices.

Abdulrahman Al-Suleiman, director of an insurance company, said the policies of the industry would change at the start of the new year. “The new measures will involve strict censure of hospitals in view of the accumulating annual losses we are incurring.”

Al-Suleiman said some hospitals collude with doctors to add extra treatment costs to increase their profits, in exchange for the practitioners receiving a certain percentage.

However, Ali Al-Shanbari, the medical director of a private hospital rejected the accusations, saying that not all hospitals are guilty of these illegal practices. “But we cannot deny that some are greedy, request unnecessary medical tests, and intentionally slow the treatment until the patient needs to be hospitalized even though they may, for example, have minor and simple intestinal or pulmonary inflammation.”

Lawyer Saeed Al-Qahtani said it is a global problem. “Such malpractices are addressed by deterrent sanctions when discovered, but should not affect the overall ties between hospitals, insurance firms and patients.”


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