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WTO worker 'defrauds' health insurer of $3.4m

Malcolm Curtis · 10 Apr 2014, 10:43

Published: 10 Apr 2014 10:43 GMT+02:00

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The Uruguay man went on trial this week in Nyon, a town in the canton of Vaud near Geneva for sending 2,700 fraudulent documents to justify expenses for medical treatment that he never received, the 20 Minutes newspaper reported on Thursday.

The man also collected benefits after falsely claiming his former wife had cancer, creating bills from fictional clinics, the newspaper said.

“We have reached the top of the pyramid in the realm of fraud,” the judge in the case is quoted as saying on Wednesday.

The defendant acknowledged starting to inflate real documents for medical prescriptions around nine years ago.

The false bills that he created were accompanied by documents necessary for the reimbursement of treatment supposedly received in Switzerland and Uruguay, 20 Minutes said.

The accused, who has been in detention for a year, testified that he sent a million francs to his home country, where his ex-wife and mother live, and he was now “ruined”.

He claimed that he suffered from depression that led him to shrug off the impact of his actions, according to the newspaper report.

His lawyer also pointed to negligence on the part of the insurance company, 20 Minutes said.

“An insurer that pays back 154 radiotherapy appointments, that’s shocking.”

An executive from the insurance company, however, said all the documents were “perfectly falsified”.

It was only in the autumn of 2012 when the insurer asked for a detailed medical report, which the accused refused to provide, that the company contacted the doctor mentioned in the false bills.

Story continues below…

The doctor informed the insurer that the man was not her patient, leading to the accused’s arrest in March 2013, 20 Minutes said.

The prosecution is seeking a prison sentence of four years for the alleged fraudster.

Sentencing in the case is expected in the next few days. 

Malcolm Curtis (news@thelocal.ch)

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