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Stamping out and stepping up

This week 11 of the UK’s leading health insurers united to form a fraud intelligence system to support the Health Insurance Counter Fraud Group’s fight against healthcare fraud.

The Group now hopes to stamp out fraudulent goings-on using its data-sharing system, designed to allow the industry to share data and intelligence with providers, doctors and hospitals. The grand unveiling takes place in Newcastle on November 20.

Healthcare fraud swallows up 5 per cent of all money paid out for PMI claims in the UK. Though this figure seems minimal, the HICF group is dedicated to driving fraudsters out of the industry, for good.

It says fraud comes in many forms and those providers unsure about detecting fraudulent behavior should take note of the following examples – providers billing for services not actually carried out and misrepresentation of facts, such as performing a cosmetic procedure such as breast enlargement and claiming that the treatment was for breast cancer.

Other forms include upcoding, meaning charging for more complex services than were actually delivered, and unbundling, charging for the same service several times and hiding it behind medical jargon.

In other news ifs School of Finance is offering advisers its CeLTCI qualification in long term care.

The move comes after Britain’s leading political parties described it as an area requiring attention during this year’s conference party season.

This week also saw online protection provider Progress boost its critical illness offering by extending the scope of cover for a number of definitions, and enhancing its product to include 40 illnesses.

The online protection arm of the Royal Liver Group now covers nine new conditions, including open-heart surgery, pulmonary artery surgery, encephalitis and rheumatoid arthritis, both acute and severe.

Progress head of protection products Stephen Edwards says: “We now cover every condition available in the market which we consider critical. The improvements add real value in terms of paying extra claims. Whilst the rarer conditions night already be covered under total permanent disability, we decided to include them as separate conditions to provide clarity and confidence that they are covered.”


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