Common malpractices in insurance claims

COMMON MALPRACTICES IN INSURANCE CLAIMS

  • Insurance on ill animals: Sometimes animals in sick conditions are insured in order to submit claims for obtaining benefits. Death of an insured animal soon after its insurance may lead to suspicion. Such claims are detected and disallowed.
  • Willful killing of an insured animal: It has been observed that sometimes after getting the desired lactation, the animals are killed by some unscrupulous methods and claim is submitted for receiving benefit from the insurance.
  • Claim for an uninsured animal: Sometimes a livestock owner uses a tag from an insured animal to claim insurance on some other dead uninsured animal. This can be detected and claim rejected.
  • Insurance of old and unproductive animals: Many a time with the connivance of more than one agency, old and unproductive animals are insured. These animals die within the insurance period and claims are submitted for payment. A technical probe can detect such frauds and claims of this nature are liable to be disallowed.
  • Tampering with ear tags: At the time of issuing health certificate the veterinarian is required to certify that the tag has been fixed to the animal's ear. Therefore, a veterinarian should get the tag fixed in his presence to avoid any complications. Sometimes ineligible animals are insured by a an unscrupulous owner and this brings liability upon the veterinarian. Sometimes ear tags are fabricated by fraudulent owners who attach it to the ear of the dead animal. This can be detected by very careful examination which will indicate that:
    • Recently fixed tag will show scratches due to stone or hammer used for fixing the tag.
    • There would be some hair growth around the tag hole in the case of a recent punch but this would be usually absent in an old tag hole.
    • Sometimes the tag is new and does not correspond to the time when the animal was insured.
    • A fresh ear hole in which the tag has been put will not show the changes usually seen in an old hole. Histopathology in such cases will reveal the presence of fibrous connective tissue at the edge of the hole if the tag is put during life time but it would be absent in case the tag is put after death or just before death.
Last modified: Tuesday, 5 June 2012, 11:19 AM