Forged papers to claim health insurance, clerk booked

  • | Wednesday | 1st November, 2023

Gurgaon: A clerk posted at an Ex-Servicemen Contributory Health Scheme (ECHS) polyclinic in Sector 47 was booked on Tuesday for fraudulently processing medical reimbursement bills of Rs 28 lakh of fictitious patients. The claim amount was transferred to two bank accounts of the accuseds accomplices.Naresh Kumar Dauchania, a resident of West Delhi, was employed as the billing clerk at ECHS polyclinic from October 2021. He was responsible for the billing section (to accept and process in-patient department claims, home isolation claims and putting claim ID).Dauchania, taking advantage of his position, processed forged medical reimbursement bills and put digital signatures of the then in-charge of the polyclinic and forwarded the claims to bill paying agency and regional centre of ECHS for approval.The fraud was detected in August during a routine audit. Dauchanias role came to light and all the claims processed by him since 2021 were checked. It was found that four fake claims were rejected while many others were cleared and the amounts were credited in the bank accounts mentioned on the claim form.Further checking revealed that all the amounts were credited in two accounts owned by Raveena Kumari and Renu Yadav, both residents of Uttam Nagar in New Delhi. When officials confronted Dauchania, he admitted his involvement in the fraud. He was then suspended.A complaint was filed by Colonel (retired) K K Sharma, in-charge of the polyclinic, at Sadar police station. Based on the complaint, an FIR was filed under sections 409 (criminal breach of trust by public servant), 420 (cheating), 467 (forging document), 468 (forgery for cheating), 471 (using forged document), 120B (criminal breach of trust) of the IPC. The investigation is under way, said police spokesperson Subhash Boken.We also published the following articles recentlyResidents contest MCDs claims of no open burningResidents in Delhi have raised concerns about the lack of action taken by the Municipal Corporation Delhi (MCD) in checking sources of pollution. While the MCD claims to have dedicated surveillance teams, residents have reported rampant waste burning and coal usage in eateries and roadside dhabas. The MCD stated that it needs evidence before penalizing violators. The MCD has issued challans and fines for violations related to construction and demolition waste but experts suggest the need for intensified inspections in far-flung residential areas and outskirts of the city.Man arrested for forging house lease documentThe son of a film financier in Chennai has been arrested by the Central Crime Branch for forging a lease document to illegally claim ownership of a property. The property belonged to a woman who had rented it out to the accuseds father. After the fathers death, the son created a fake lease document stating that he had paid a large sum of money and forged the womans signature. The accused has been remanded in judicial custody.Lack of awareness plagues LPG claimsThe lack of awareness about insurance for gas cylinder blast victims is affecting the claim process, as seen in recent incidents in Andhra Pradesh. In a cylinder blast in Kurnool, the family of the deceased had to fight for compensation, while in Anantapur, third-party intervention was needed to obtain insurance claims. Families are entitled to claim 6 lakh per person and 2 lakh for medical expenses, but many victims do not approach the gas distributor or company for compensation. Increased awareness is needed to help victims access medical treatment and insurance benefits.

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