10 ‘patients' forge mediclaim papers to pocket Rs one crore
bogus patients
who forged mediclaim papers using fake stamps and signatures of two hospitals, PP Savani Heart Institute and Multispeciality Hospital, and Diamond Hospital, to fraudulently get claims amounting to a total of Rs one crore.
The accused complained of various issues like chest pain, vomiting, and nausea and got admitted to these hospitals. They then filed claims up to Rs one crore under their critical care policies.
As the insurance firms sent the papers for verification to the hospitals, the doctors there were shocked to see their forged stamps and signatures used in Part-B forms of claims. The Part B forms are generally signed and filled by hospitals. Kapodra police booked all 10 patients in two different FIRs for forgery and started an investigation.
The first FIR was filed by Dr Anil Tanti, administrator of PP Savani Heart Institute and Multispeciality Hospital, against the six 'patients'. They included Ketan Dholariya, Jayaben Chovadiya, Bipin Bhanderi, Kamlesh Suhagiya, Satish Dhaduk, and Pratik Vaghasiya. These accused got themselves admitted to Tanti's hospital by complaining of various ailments like chest pain, vomiting, and nausea, among others, during December 2024 to April 2025. These accused filed a mediclaim of Rs 15 lakhs to Rs 1.10 crore with various insurance companies under their policies. When the companies sent the documents to the hospital, they found that cardiograms, blood reports, prescriptions, and other documents were either fake or forged. The accused also used the hospital's stamps and signatures, which were forged.
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The second complaint was filed by Dr Haresh Pagda, administrator of Matushri Ramuba Tejani and Matushri Shantaba Vidiya Hospital (Diamond Hospital), against four 'patients'. They included Nayan Desai, Jagdish Kachhadiya, Ghanshyam Pedhadiya, and Aruna Bhatt. They filed claim papers for Rs 50 lakh to Rs one crore mediclaim amount with various insurance firms during November 2024 to April 2025.
When these firms sent the papers to the hospital, it was revealed that the papers were forged as the stamps and signatures were forged on documents. These patients got themselves admitted to the hospital for some or other ailment, but the papers they sent to the firm were fake or forged.
Kapodra police inspector MB Ausura told TOI: "Based on complaints by both the hospitals, we started investigations. We have not made any arrests yet, but we doubt the role of any agent in this scam. We will soon nab the accused."
The firms to which the claims were filed included Bajaj Allianz General Insurance, Star Health Insurance, NivaBupa Health Insurance, Tata AIG General Insurance, The Oriental Insurance, ManipalCigna Health Insurance, Reliance General Insurance, and IFFCO-Tokio General Insurance.
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