Medical Claims

Centricity investigates medical claims across every major continent and the majority of claims we see relate to inflated claims, non-existent facilities or cosmetic surgery claims disguised as accidents in order to facilitate cover.

All too often when the practitioner is interviewed key facts of the alleged treatment are uncovered often implicating the insured and the practitioner in an alleged fraud. Common elements and key fraud indicators are readily identified in the documentation and the receipts are one area attracting close scrutiny as well as the cost of treatment which is usually inflated.

In many instances the facilities claimed do not exist and claimants have used the internet to source logos and download key medical information including fake MRI Scans inserted into medical reports for a realistic presentation of the facts.

In large loss medical claims, Centricity covers all these issues including detailed interviews and, with authorisation, access to medical files to determine pre-existing conditions.