Gujarat: Doctor, insurance company staffer booked for Rs 33 lakh fraud

AHMEDABAD: Infocity police of Gandhinagar have booked a Surat-based doctor and an insurance company employee for fraudulently making Rs 33 lakh by getting 69 medical claims sanctioned under the Ayushman Bharat scheme of the Union government between 2018 and 2020.

Dipak Verma, 36, a resident of Infocity who works as the Gujarat head of Vidal Health Insurance TPA Private Limited, said in his FIR that his insurance company worked with Oriental Insurance to provide medical claims under the Ayushman Bharat scheme. Vidal had a contract with Oriental Insurance between 2018 and 2021. Vidal was given the task of making a file of the patients and their claims from the hospitals concerned and submitting the file to the government.

In June 2020, the head officer of Vidal directed the then Gujarat head, Naveen Thakur, to check all the claims as there were some discrepancies in the claims made from a hospital in Surat.

Thakur checked all the claims and found that 69 patients whose names were sent to the government had not taken treatment under the Ayushman Bharat scheme. According to the FIR, 83 claims were made from Samarpan Multi-specialty Hospital in Surat of which 69 claims were fake and 12 had some faults in them. Only two claims were found to be genuine, mentioned the FIR.

On inquiring into the case, cops found that an insurance company employee named Kunal Bokade, who prepared the Excel sheet of the patients, had in connivance with Dr Rasik Virani of Samarpan Hospital committed fraud. The two were booked on Friday.

At Virani's behest, Bokade used to send the final Excel sheet to government to get money on false claims. Virani made Rs 33 lakh. The investigators are yet to determine how much Bokade got from the scam.

Infocity police have registered a complaint under the charges of forgery and breach of trust along with criminal conspiracy against Bokade and Virani.