More fraud - insurance this time.

RE: More fraud - insurance this time.

Richard Carter — Sun, 05 Jul 2015 21:31:35 GMT

The RCVS idea of data protection is incorrect - the history is relevant to your patient and is not under data protection - the same as if you bought a car from someone and they forgot to mention the complete rebuild it had had - you can HPI check it - who owns the patient is irrelevant and the history stays with the patient, it is not 'owned' by the previous owner and therefore they do not have a say.

What you cannot do is provide names and addresses and other personal details (eg financial agreements) to a third party.

RE: More fraud - insurance this time.

Stephen Courtney — Sun, 05 Jul 2015 12:06:55 GMT

Thanks for clarifying - that's something I hadn't considered - I suppose the best thing would be to get the new oner to ge the consent and make it their problem. But to be honest until this thread came up I would have simply provided the history. /

with our PMS / record system when an animal is transferred from one client to another ( i.e. rehomed within the client base) the record is usually transferred in toto to the new client's registration details so the history stays with the animal anyway - so perhaps we need to rethink that...

RE: More fraud - insurance this time.

Catriona MacIntyre — Sun, 05 Jul 2015 10:27:22 GMT

[quote user="Stephen Courtney"]Regarding the anecdote about the former owner not consenting to send a clinical history - personally i would have sent the history, just removed the owner's details - and certified that it was a true reflection of our data[/quote]

Would that life were so simple!

Not in a small town where the current owner would turn up at the previous owner's house yelling because they'd paid out thousands on getting the dogs stifle fixed and the previous owner had said nothing about it at rehoming.

They weren't going to get the payout no matter what I did, and the advice from RCVS was that I should not release the history without consent.

RE: More fraud - insurance this time.

Stephen Courtney — Sun, 05 Jul 2015 09:20:42 GMT

Are there insurance companies on here? Hope not given some of the things that have been said from time to time!

Regarding the anecdote about the former owner not consenting to send a clinical history - personally i would have sent the history, just removed the owner's details - and certified that it was a true reflection of our data

I would have done that without hesitation or worrying about permission. the record belongs to us, and so long as the private details are removed, what is the problem?

RE: More fraud - insurance this time.

mariette asselbergs — Sat, 04 Jul 2015 11:28:23 GMT

Any insurance company on the forum to comment?

Mariette

RE: More fraud - insurance this time.

Hannah Wynne Richards — Sat, 04 Jul 2015 10:55:49 GMT

Sounds a good idea, but I genuinely don't know if such a contract would be legally enforcable.

Wynne

RE: More fraud - insurance this time.

mariette asselbergs — Sat, 04 Jul 2015 10:51:23 GMT

[quote user="Hannah Wynne Richards"]

But there's no guarantee that some people won't be so evil as to insure - treat - drop insurence - another condition develops - insure with another insurence comapny - treat - drop insurence. Then premiums escalate - then honest people get put off insuring - then even more animals suffer.

Wynne

[/quote]

Well, if I were the insurance company I would arrange a legal possibility for people to start insurance on the start of a condition with an obligation to stay insured for x years or life of pet. Surely that must be legally possible, if you buy a car on a monthly contract you can't stop paying. Or if your employer pays your cert course on the condition that you pay back if you leave that is all enforceable no so?

Mariette

Re: More fraud - insurance this time.

Hannah Wynne Richards — Tue, 30 Jun 2015 18:44:59 GMT

Wynne

Re: More fraud - insurance this time.

mariette asselbergs — Tue, 30 Jun 2015 18:08:23 GMT

Of course, it is all criminal and illegal.

BUT

1) Where is the animal's welfare in this discussion? What is best for the animal?

2) For the insurance company, what is actually the difference financially, between an animal that has been insured for say 6 weeks and then needs surgery or investigations or hospitalisation. And an animal that has just been insured, then immediately needs veterinary interventions, and then stays insured for the rest of its life since the owner has now seen the usefulness of it? If I were an insurance company I would think twice before putting potential lifelong clients off for claiming early, and I have felt really sorry for puppies and kittens that were diagnosed at first health check/vaccination with a congenital heart condition with no hope to get insured or helped.

Mariette

Re: More fraud - insurance this time.

Hannah Wynne Richards — Mon, 29 Jun 2015 08:57:28 GMT

As always, a few evil ones spoil everything for the good people. What's needed are more prosecutions, and DETERRANT SENTENCES

Wynne

Re: More fraud - insurance this time.

Catriona MacIntyre — Sun, 28 Jun 2015 18:40:30 GMT

I think that some insurers ARE seriously tackling the problem.

I have seen a couple of claims turned down because owners could not give vets details to allow a full history to be obtained. In one case, this was because the dog had been rehomed, and the previous owner, also a client, would not return phone calls or written correspondence from us requesting permission to release records to the new owner's insurance company.

The claim was refused and sadly the new owner's have decided it is our fault because we refused to release the previous records without consent from the previous owner. Ironically, if we had been able to release the records, the claim would have been refused as a pre-existing condition.

Re: More fraud - insurance this time.

grumpyoldman — Sun, 28 Jun 2015 17:13:47 GMT

Yesterday morning I eaves dropped on two separate conversations involving the duty nurse and 2 clients in that limbo phase between initial radiography revealing terrible surgical stifle and hip problems ,both were wondering how they could possibly pull an insurance fast one and finance the surgery that way . She dismissed the enquiries with the old "insuring your car post prang scenario", and confirmed that we were unable to re-enter the computer software and change things or get involved in any fraudulent activity . Neither booked their surgery in and both will probably work it out ,you can almost read their minds by the address and post code.

In the afternoon ,at a different surgery in a different part of the city a new client appeared with a CCL rupture, and no previous vets and a 6 week old Marks and Spencers policy ........................................maybe genuine ,perhaps 3yrs 3 months is a good age to suddenly just randomly insure you fat spayed rottie Bitch ? He could not remember where it was spayed ?

I cannot help wondering what all this is costing the likes of RSA and maybe sorting it out would go some way to avoid having to haggle down the price of those TPLOs (totally profitable leg operations).

A few years ago a client came in demanding that we claimed for her pets anal sac removals on a new policy because if we did not ,she had contacted her friend who worked as a receptionist at another local practice who had told her that she often edited dates and adjusted histories to allow the smooth flow of insurance claims, they often did it when clients were having trouble with vets who would not co-operate . On its own "tittle tattle" ,but not an isolated incident ,I contacted their head office where denial was not just a river in egypt ,and just said if I heard anymore I would make a few notes and pass them on to the relevant insurers. It did stop after that. Or they were just a bit more tight lipped about it ,hard to know?.

Re: More fraud - insurance this time.

Evelyn Barbour-Hill — Sun, 28 Jun 2015 14:16:45 GMT

[quote user="Hannah Wynne Richards"] It can be innocent, but partnerships can be a cause of confusion - the animal is owned by Mr A and Miss B - or Mr C and Mr D or Ms E and Ms F.[/quote]

And when they phone for an appointment they can never remember which name they are under........

Re: More fraud - insurance this time.

Hannah Wynne Richards — Sun, 28 Jun 2015 11:31:10 GMT

It's less of a problem in a small practice, but even I have had the occasional double-registration. It can be innocent, but partnerships can be a cause of confusion - the animal is owned by Mr A and Miss B - or Mr C and Mr D or Ms E and Ms F.

Wynne

Re: More fraud - insurance this time.

grumpyoldman — Sun, 28 Jun 2015 00:18:11 GMT

[quote user="Stephen Courtney"]So not recognising a client or their animal is perhaps not impossible.[/quote]

I cant speak for anyone else but I never forget a scumbag . I have then come in with different surname address and partner 10 years post bad debt , caught them in the waiting room and made a point of recognising them and suggesting they went elsewhere immediately. When its your money you do not forget a gargoyle.

Re: More fraud - insurance this time.

Stephen Courtney — Sat, 27 Jun 2015 22:44:09 GMT

We are a multi vet and branch practice, and often have clients double registering, sometimes by mistake ( receptionist enters name with different spelling etc) and sometimes because a bad debtor is deliberately doing the rounds - they can take a fair bit of catching unfortunately, registering under various family member's names, and suddenly no one is responsible for the previous debt....then start registering under a new address and start the whole thing over again!

So not recognising a client or their animal is perhaps not impossible. And i sometimes don't recognise the client 2 minutes later - for instance if a handbag or keys left behind and the waiting room has a few people in it...who have i just spent 10 minutes with.... can be very embarrassing!

Re: More fraud - insurance this time.

ruths — Tue, 23 Jun 2015 07:09:17 GMT

[quote user="Luca Poddighe"]

Yes, that's the one... and suprisingly the vet doesn't recognize he's treating the same dog and the same owner under two different names. -_-'

[/quote] It reminded me of one of my favourite children's books, Six Dinner Sid

Re: More fraud - insurance this time.

grumpyoldman — Tue, 23 Jun 2015 07:04:03 GMT

[quote user="Hannah Wynne Richards"]I've read it. There was certainly grounds for a trial/DC hearing.[/quote]

I read it and thought ,what an excellent defence team, maybe someone will now "quit while they are ahead" , wondered if anyone had taken a trip through the database and found any similar double registrations?. I expect that when huge vets of smart town Ltd move in and take over the database will go to make way for a new system and all the existing clients will have to re-register ,that seems to be what usually happens in these situations.

Re: More fraud - insurance this time.

Braden Collins — Mon, 22 Jun 2015 23:47:54 GMT

Had a client a few weeks ago come in to have a lump checked and "while I'm here can you just check his back end". Diagnosed bilateral CCL rupture. The client then mentioned she had just insured the dog a few week before. What a happy coincidence. Warned owner about waiting times with these things but she still went ahead with referral for surgery. Client then rocked up with the cruciate check form from the insurance company, wanting me to fill it in saying the dog had no evidence of cruciate disease. They threatened reporting me to the vet surgeons board and legal action if I didn't fill it in. Not the sort of client anyone needs and now sacked.

Re: More fraud - insurance this time.

Robin Grimmer — Mon, 22 Jun 2015 19:44:25 GMT

[quote user="Gerry Henry"]

Knobbly joints, lameness, muscle atrophy, stiffness.

[/quote]

That's all very well if fairly advanced arthritis. But if mild or early these signs might be absent. I could see a potential minefield of litigation similar to horse vettings.

Re: More fraud - insurance this time.

Gerry Henry — Mon, 22 Jun 2015 18:50:28 GMT

Knobbly joints, lameness, muscle atrophy, stiffness.

Re: More fraud - insurance this time.

Robin Grimmer — Mon, 22 Jun 2015 16:36:53 GMT

[quote user="Gerry Henry"]

Alternatively they should require that every animal is health checked prior to being insured, never could understand why this wasn't done as routine.

[/quote]

Sounds good in theory, but how easy would it be say to miss say, arthritis?

Re: More fraud - insurance this time.

Luca Poddighe — Mon, 22 Jun 2015 15:30:32 GMT

[quote user="Hannah Wynne Richards"]Sometimes, one is left with "the Scottish verdict" - not proven.[/quote]

That's my feeling too. With compulsory microchip, considering that we'll have to check all new animals, these ambigous situation will come to an end hopefully.

P.s. Thank you Redstarman for your attention

Re: More fraud - insurance this time.

Hannah Wynne Richards — Mon, 22 Jun 2015 11:59:17 GMT

It's like with a criminal trial. Once there is a certain level of suspicion, the correct course of action is to proceed to a trial, when either proof beyond reasonable doubt will emerge - or not. Sometimes, one is left with "the Scottish verdict" - not proven.

Wynne

Re: More fraud - insurance this time.

Bob Russell — Mon, 22 Jun 2015 11:27:57 GMT

The case revolves round "he said, she said".The client claims the vets advised taking out a new policy under different details.

The case was dismissed because there is no evidence that any wrongdoing took place on the part of the vet. We can all have an opinion on the likelihood of what, if any, fraud took place.

The reality was it was all suspicion and no facts therefore dismissing the case would seem appropriate.

I agree that microchip recording on forms should be a requirement where a chip is present.