Nghe An police investigate and clarify a ring of fake medical records to benefit from insurance.

On July 24, 2023, the Investigation Police Agency of Nghe An Province Police issued a Decision to prosecute the case and prosecute the defendants to investigate and clarify the acts.fraud and appropriation of property, forgery at work, fraud in health insurance to profit from life insurance money, causing damage to health insurance occurred in a number of hospitals and medical facilities in the province, initially arrested 5 related subjects.

Previously, through the investigation, Nghe An Provincial Police discovered a group of subjects who colluded with medical staff in hospitals to create fake medical records for treating accidents, burns and some other common diseases to profit from life insurance and health insurance. Under the direct direction of the Provincial Police leaders and the Chief of the Investigation Police Agency, the Department of Investigation Police on Corruption, Economy and Smuggling of Nghe An Provincial Police established a special project to fight and clarify.

After a period of focused investigation, the Police Agency determined: Due to knowledge of insurance packages as well as how to prepare insurance benefit payment records for customers of a number of life insurance companies, the subjects Le Thi Ha An (born in 1989), residing in Block 2, Quan Bau Ward, Vinh City; Nguyen Thi Quynh An (born in 1988), residing in Nghi Kim Commune, Vinh City and Thai Thi Mai (born in 1967) residing in Block 4, Tan Ky Town (An's mother, a former nurse at Tan Ky District Medical Center) colluded with Nguyen Quoc Viet (born in 1984) residing in Block 3, Tan Ky Town, an X-ray technician at Tan Ky District Medical Center to falsify medical records of broken bones for people who needed to prepare medical records to request payment of life insurance benefits.

For each fake medical record, the subjects paid Viet from 2.5 to 5 million VND. After obtaining the fake medical records, the subjects transferred them to those who needed to make records to pay for insurance with an amount from 300 to 400 million VND/01 set of medical records. For each case paid by the insurance company, Le Thi Ha An benefited from 100 million to 200 million VND.

Expanding the investigation, the Police discovered that Le Thi Ha An also colluded with Tran Duc Luong (born in 1982), residing in Trung Hoa block, Ha Huy Tap ward, Vinh city, a doctor in the Department of Cardiology, Vinh University of Medicine and Pharmacy Hospital, to create fake medical records to fraudulently pay for insurance money.

Accordingly, Tran Duc Luong received information about people who needed to make medical records for the day of hospitalization from Le Thi Ha An and some other subjects such as: Hoang Thi Hien, Nguyen Thi Ngoc (nurses at Vinh Medical University Hospital), Vo Thi Van Anh (consultant of Bao Viet Life Insurance Corporation) and then performed the procedures for medical examination, hospitalization, treatment prescription, prescription of medicine... according to the hospital's procedures. When it was time to leave the hospital, Luong completed the discharge procedures for the patients and gave copies of the medical records to Le Thi Ha An and those who asked Luong to make the medical records.

Initial investigation revealed that the subjects had fabricated hundreds of medical records to appropriate life insurance money and health insurance benefits totaling a huge sum of about 10 billion VND. The actions of the above subjects caused losses to the State budget, affected the operations of businesses, and affected the reputation of hospitals and medical facilities.

Currently, the Investigation Police Agency of Nghe An Province has issued a decision to prosecute Le Thi Ha An, Nguyen Thi Quynh An, Thai Thi Mai for the crime of "Fraudulent appropriation of property"; Nguyen Quoc Viet for the crime of "forgery in work"; Tran Duc Luong for the crime of "Health insurance fraud". The police agency is also continuing to clarify the actions of other related subjects.