Isn’t it that he was the surgeon? So he billed the insurance for himself and paid himself the money. Instead of the money going to the hospital and some portion of it going towards his paycheck, but most of it going towards the cost of running and supplying a hospital with all the tech and tools they need to stay current and have competitive success rates.
Or did he just claim disability or something by way of accident instead of by choice, to get a higher disability insurance pay out?
Either way, fraud is basically any time you lie to get money, criminal fraud is when you lie to get enough money that the police care. And it certainly seems like he lied to get more money than he was entitled.
I would be very impressed if he surgically removed his own legs. I mean, there is a lot of tissue and bone to cut through. That’s not easy to do by yourself. But if that’s the case, that’s where the fraud aspect could come from.
Also, is that a thing? “Disability by choice” so you get a lower payout? But even if, wouldn’t that be paid by some other insurance - like a specific disability insurance rather than your typical health insurance? At least in Germany the latter is very much different, health insurances only pay for treatments, recovery and prevention.
The lie about the cause of the injury must somehow be related to the payout, otherwise I can’t believe how it would constitute fraud. Still, this is really confusing because private health insurances usually cannot decline/reduce claims due to intentional injury.
Also, it looks like “old mutual health” was recently re-branded to “ReAssure” in the UK, so that would be who to look up for what type of insurance they would provide. It does sound like they were life insurance, or “life assurance” as they called it. Sounds very much like disability insurance would be under their umbrella.
Isn’t it that he was the surgeon? So he billed the insurance for himself and paid himself the money. Instead of the money going to the hospital and some portion of it going towards his paycheck, but most of it going towards the cost of running and supplying a hospital with all the tech and tools they need to stay current and have competitive success rates.
Or did he just claim disability or something by way of accident instead of by choice, to get a higher disability insurance pay out?
Either way, fraud is basically any time you lie to get money, criminal fraud is when you lie to get enough money that the police care. And it certainly seems like he lied to get more money than he was entitled.
I would be very impressed if he surgically removed his own legs. I mean, there is a lot of tissue and bone to cut through. That’s not easy to do by yourself. But if that’s the case, that’s where the fraud aspect could come from.
Also, is that a thing? “Disability by choice” so you get a lower payout? But even if, wouldn’t that be paid by some other insurance - like a specific disability insurance rather than your typical health insurance? At least in Germany the latter is very much different, health insurances only pay for treatments, recovery and prevention.
The lie about the cause of the injury must somehow be related to the payout, otherwise I can’t believe how it would constitute fraud. Still, this is really confusing because private health insurances usually cannot decline/reduce claims due to intentional injury.
Its possible to do but you gotta do a lot of yoga…
Also, it looks like “old mutual health” was recently re-branded to “ReAssure” in the UK, so that would be who to look up for what type of insurance they would provide. It does sound like they were life insurance, or “life assurance” as they called it. Sounds very much like disability insurance would be under their umbrella.
No, that’s Old Mutual Wealth which rebranded. Wealth, not Health. Maybe this is a mistake in the article?
Oh, as far as I could tell they were part of the same company, the health was an umbrella with the wealth one under it.
Huh, you’re right but the umbrella company was still only called “Old Mutual”.
That makes more sense.