Health insurers can swap fraude data on new web service.
Health insurers can expect to save millions of pounds by using a data-sharing website that will help crack down on bogus claims, according to an anti-fraud group.
Insurers including AXA, PruHealth, Bupa and Western Provident Association (WPA) have signed up to use the counter-fraud system.
Simon Peck, a spokesman for the Health Insurance Counter Fraud Group (HICGP), which set up the website, said the system could help insurers make savings “in the millions” when it is fully operational by the end of 2009.
“For too long companies have worked in isolation and, when a fraud is discovered by one company, it simply shifts to another. The mission of our groups is to pool our resources and knowledge to drive the fraudsters of out the industry,” said Peck.
The data sharing will allow insurance companies to log details of suspected fraudsters. The information can then be shared with other firms. The site offers an alert system for repeat offenders.
There will also be a forum and a section where members of the public can act as whistleblowers.
Peck said: “Most health fraud is carried out by providers of medical services. Doctors are the worst group for doing it, largely through upcoding. This is when they claim a greater operational procedure that has actually been done.”
Insurers are more willing to work together after recent successful prosecutions. Bupa, AXA, WPA and Norwich Union worked together to help prosecute a doctor who defrauded insurers for at least £85,000. The doctor, who was convicted in May, billed for more expensive treatments than he had carried out.
Consumers are also culprits by not telling health insurers about pre-existing conditions. In dentistry, patients claim work on their teeth is because of serious injury or illness rather than for cosmetic reasons.
Peck said: “I would like to stress that the vast majority in the industry are honest. It is easy to forget that. We deal with only a small number of rotten apples that we are hoping to throw out.”