Many are the people who think they are spending unnecessary money with insurance and many others are those who consider that since they pay they can also get some extra benefit, albeit illicitly. If people are based on this way of thinking, Fraud and Insurance Scams inevitably arise. This type of crime consists of swindling through conscious actions or omissions in order to reach an economic benefit of the insurance entities, and that undoubtedly does not belong to them. 

Although many times they are not discovered, many of these scammers make mistakes or mistakenly execute the plan they had in mind and end up being caught by private detectives, tasked with proving these fraudulent acts and providing evidence to insurance companies. Probably what many do not know is that from the legal point of view, according to the criminal code for the crime of fraud, the planned punishment ranges from six months to three years in prison. 

And in reality, jail sentences for cases where fraud is evident to insurers have increased in a considered manner. Many of these absurd plans seem like real movie movies. From the simulations of running over to the most mediatic cases like operations of unreal hemorrhoids. Here the only purpose is to cheat without moral and irrational limits. 

An insurer hired us to find out several suspected cases of hemorrhoid surgeries where reimbursement of medical expenses was requested. All these cases were identical, they came from the same medical center and were always from the same surgeon. The profiles of the patients were similar: young women with a similar socioeconomic situation and with problems of hemorrhoids in need of surgery. Everything indicated that it was a fraud. 

The work of our private research agency proved that the doctor in question in addition to not performing hemorrhoids, but aesthetic surgeries, more specifically rhinoplasty, also delivered the documentation of these surgical procedures to insurers as if a general surgery was given that aesthetics were not covered by insurance. 

Here the work of our team of researchers to dismantle a relevant scam was undoubtedly essential. 

Sindia Alves and A. Oliver

Anthropologist and Private Investigator
of Oliver Detectives