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Man jailed for £24k bogus medical insurance claims

Man jailed for £24k bogus medical insurance claims
 

A man from Yorkshire has been jailed after attempting to defraud three insurance companies by making bogus claims for medical treatment, totalling around £24,000.

According to the City of London Police, Benjamin Wilby, 34, of Pontefract, submitted more than 100 claims in nine different names between December 2018 and September 2019.

An unusual pattern of claims was identified by an insurer, which led the company to refer the case to the City of London Police’s Insurance Fraud Enforcement Department (IFED).

Wilby was sentenced to 12 months' imprisonment on Monday 8 August 2022 at Leeds Crown Court. He previously pleaded guilty to three counts of fraud by false representation.

The insurer had looked into four policies, which had a similar pattern of claims and all were located in the Yorkshire area, believing there to be one individual behind these policies.

During the investigation, the insurer uncovered a total of 54 claims linked to these policies. Following this, the insurer referred the case to IFED for further investigation.

The insurance company contacted the 10 medical professionals that were listed on the claims to ask about the treatments they had supposedly provided.

The providers confirmed they had not administered these treatments and that the receipts given by the policyholders were fake.

IFED officers arrested Wilby at a family member’s house in September 2019.

While executing a search warrant on the property, officers found various pieces of evidence indicating that Wilby had orchestrated 134 fraudulent claims with the insurer.

The unit found further evidence suggesting that Wilby had submitted similar claims with two other insurance companies.

Detective Constable Surinder Ram, from the City of London Police’s IFED, said: “Although each claim made by Wilby was relatively low in value, the large volume of bogus claims he submitted totalled a whopping £24,000.

"As well as this, he inflicted further loss on the three insurance companies he targeted due to the hours that went into their teams looking into these claims.

“The outcome of this case shows that fraud will not be tolerated at any level. IFED and the industry will continue to work together to ensure that fraudsters are stopped and brought to justice."

Short on money

According to the City of London Police, during an interview with IFED officers, Wilby took full responsibility for the bogus claims.

He admitted that he previously had health insurance with one of the providers through a former employer, and therefore knew how the cover worked.

As he was short on money, he took out four policies in different names for the purpose of committing fraud. He used computers both at home and in his local library to forge receipts from medical professionals, taking logos from the internet.

Wilby also confessed that he used his grandmother’s bank account details to receive the payments from the claims. He had opened bank accounts in her name, which he controlled without her being aware of their existence.