Imprisonment for multiple fraud at your own private health insurance

Imprisonment for multiple fraud at your own private health insurance

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Munich District Court suspends punishment for pensioners on probation

Anyone who cheats on their private health insurance for a long period of time must face a prison sentence. With a judgment announced on March 25, 2019, the Munich District Court imposed a 14-month prison sentence on a 61-year-old pensioner, but suspended it for probation (file number: 852 Ds 566 Js 216500/17).

From June 2011 to October 2013, the former IT management consultant submitted 16 invoices from a doctor about services that she had never performed. A massage therapist had also completely invented two invoices and raised 16 more due to services not performed. In total, the health insurance paid out 13,550 euros, half of which the insured passed on to the doctor or the masseur.

As a motive, the man stated that he did not want to leave any debts, but he had to spend around 1,000 euros up to 250 euros on medicines from his monthly income. He should now pay another 50 euros a month to his health insurance company.

The competent magistrate judged the acts as "fraud in particularly serious cases". At the expense of the pensioner, she evaluated the number of bogus bills and the duration of the fraud.

However, despite a criminal case still pending against him, the massage therapist had already admitted that he had initiated the fraud.

The district court also found that health insurance made fraud very easy. Because the doctor had billed identical treatments for several patients despite different diagnoses. The invoices were immediately identified as incorrect, because the doctor had given neither a tax number nor an invoice number.

Because of this, and because the pensioner had given credible assurance that he would pay off his debts and "want to live in an orderly manner" in the future, the judge suspended the sentence.

Both the pensioner and the public prosecutor did not appeal immediately after the announcement. The judgment of the Munich Local Court on February 27, 2019 is therefore already final. mwo / fle

Author and source information

Video: Health Care Fraud Prevention Summit, Chicago IL Part 1 (July 2022).


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