Saudi Arabia - Fraud caused high claim rejection ratio
Wednesday, 12 27 2017, Category: Insurance and Reinsurance, Country: Saudi Arabia
Insurance companies have reported that fraud was responsible for a 25 percent increase in rejection of medical claims submitted on behalf of patients.
Insurance experts said fraudulent practices ranged from charging companies costs not covered by companies to conspiring with doctors to submit fake claims.
They warned patients or service providers who exploit the insurance system by manipulating bills will not escape legal accountability and could be charged with fraud and forgery.
They said cases of manipulation and exploitation reflect primarily on the high prices of medical insurance in the Kingdom.
Insurance specialist Dr. Fahad Al-Enezi said, “Exploiting medical insurance by over-prescription of medicines and laboratory investigations, billing of services not covered in basic policy is common in all regions and countries of the world.”
Source: Saudi Gazette