Gurugram: A large-scale insurance fraud network allegedly operating through fake hospitals and fabricated medical records has been exposed in Gurugram. Investigation agencies said that the syndicate was involved in creating bogus patients and forged medical documents to illegally obtain insurance claim payments. Following a police raid, several critical details have emerged, raising suspicion about the possible involvement of a larger criminal network.
Raid at Galaxy One Hospital Uncovers Suspicious Claims
The case surfaced after a recent raid at Galaxy One Hospital located in New Nihal Colony. Investigators believe that the hospital was established primarily to carry out insurance fraud. Authorities alleged that the hospital operator, identified as A S Yadav, along with his two sons and several employees, was running the network.
Officials said that the accused had created paper hospitals in locations including Farukhnagar and Dwarka in Gurugram district. These facilities reportedly functioned for nearly two years starting in 2018 with the sole intention of committing fraud. Inside these alleged medical units, no genuine patient treatment was conducted; instead, documents were prepared only to support insurance claims.
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Fake Hospitals and Fabricated Medical Records
Investigators recovered around 60 suspicious insurance claim files from the hospital, which were linked to nearly 25 insurance companies. Preliminary assessment suggests that the total fraud amount could be at least ₹1 crore, though authorities believe the figure may increase as the probe progresses.
Police said the gang operated in a highly organized manner. A hospital structure that appeared legitimate was first established. Employees and allegedly compromised doctors then prepared fake admission records, laboratory reports, pharmacy bills and treatment documents to create the illusion of real medical treatment.
‘Ghost Patients’ and Identity Documents Used in Scheme
The network also allegedly recruited individuals willing to provide their Aadhaar and other identification documents. These people were shown as patients in medical records and insurance claims were filed in their names. After claim approval, the beneficiaries would receive the money and pass a portion of it as commission to the network.
Investigators also found that some individuals posing as private investigators for insurance companies played a significant role in the racket. Officials suspect that these so-called investigators acted as intermediaries and helped push fraudulent claims for approval.
Arrests Made as Wider Network Comes Under Scanner
Police have arrested three employees in connection with the case, identified as Sapna, Varsha, and Gaurav, a resident of Rajasthan. Authorities said these individuals were involved in preparing fake admission registers and laboratory test reports.
The investigation also revealed that accused A S Yadav attempted to use fake medical degrees, including MBBS and MD certificates, to support his professional identity. A previous probe by the Chief Minister’s flying squad had already found that the claimed MD degree was not genuine. Police have frozen several bank accounts linked to the accused, though only a small amount of money was found in them.
Over 500 Suspects Under Investigation
Officials estimate that more than 500 fake patients may have been involved in the racket. Most of the suspects are currently at large, and a Special Investigation Team has been formed to track them down. Health department officials are also assisting in the raid operations.
Authorities are also examining how cash transactions were used in the movement of fraudulently obtained money. Investigators said that in several instances, the funds were transferred through multiple accounts, making it difficult to trace the money trail.
Police have indicated that assets linked to the accused may be seized and auctioned to provide compensation to victims. The investigation is still at a preliminary stage, and more arrests are expected in the coming days as the network is further exposed.
