The General Insurance companies have decided to take stern action against fraudulent medical claims, including filing FIRs. The companies may take action for even smaller amounts, sources told ET now.
Companies decided to adopt filing FIRs as deterrent strategy
Earlier, companies were reluctant to take the legal route due to the lengthy process. Now, insurance companies have decided to adopt filing FIRs as a deterrent strategy to protect genuine policyholders.
According to ET Now, the general and health insurers paid Rs 87000 crore in health claims in fiscal year 2024.
Impacted genuine policyholders
A CEO of a leading general insurance company said that insurers have decided to file FIRs against fraud claims to keep a check on overall outgo claims. He said such frauds have also impacted genuine policyholders.
Sources further added that the move aims to control the premium hikes by checking fraud claims as the government insurance regulator IRDAI, Prime Minister’s Office (PMO) and Department of Financial Services asked the companies to make health insurance more affordable.
‘Even small frauds of Rs 20,000 are being acted upon’
“Earlier, we used to detect and reject fraudulent claims but avoided filing FIRs due to the long process. That’s changing now. Even small frauds of Rs 20,000 are being acted upon because they can snowball into larger losses. FIRs are now being filed—even against policyholders—to deter such practices,” ET Now quoted a senior executive as saying.
Another executive said that medical and age inflations are beyond their control, but admitted that intervention is possible in cases of fraud, medical bills, wastage, and abuse.
