Five arrested in fraudulent insurance claim case

Rajkot: The authorities here on Saturday arrested Mayur Chhuchhar, the policyholder who allegedly made a fraudulent medical insurance claim for Rs 40 lakh saying he was paralysed, and his physiotherapist accomplice Ankit Kathrani, who allegedly helped him prepare the fraudulent documentation.

Police also arrested Bhavik Makad, an employee of a private hospital who allegedly created false records. Hitesh Ravaiya allegedly helped Katharani fabricate MRI reports by enlisting Himanshu Rathod, a laboratory worker. Ravaiya and Rathod were also arrested on Saturday.

Assistant commissioner of police (west) Radhika Bharai said, "Chhuchhar and Kathrani had planned the fraud. Chhuchhar was to give Rs 10 lakh to Ankit if everything went according to plan and he was paid Rs 40 lakh."

The investigation found that Chhuchhar, a tea stall owner, befriended Kathrani, who was a regular customer.

Chhuchhar sought Ankit's advice regarding his Rs 40 lakh health policy. Ankit devised a scheme suggesting a paralysis treatment claim, promising substantial compensation upon success.

To get false medical documentation, Ankit contacted Ravaiya, who used to organize hospital events. Ravaiya approached Himanshu Rathod at Sahyog Imagine Centre to produce the fraudulent MRI reports. Ravaiya received Rs 5,000 for this service, and he gave Rs 2,500 to Rathod.

For hospital admission requirements, Ankit contacted Bhavik Makad, an administrator at Samarpan Hospital. Mankad facilitated Chhuchhar's admission, citing hypertension and fever.

"Makad helped to prepare the forged file from Samarpan Hospital and would enable Chhuchhar to go home at night and get back to the hospital bed in the morning Chhuchhar before the doctors arrived," added Bharai.

Police reports indicate Mankad helped create documentation showing treatment for a paralytic attack, but errors in the forged papers left room for suspicion for the insurance company's investigators.

Officials of the insurer's third-party administrators (TPA) noticed discrepancies between two doctors' reports from the same hospital, with conflicting details about which body side was affected. The Civil Hospital MRI report lacked proper documentation and contained suspicious elements, including a signature without the radiologist's name.

The investigation ended when TPA officials found Chhuchhar running his tea stall and riding a motorcycle. After this was caught on video, Chhuchhar submitted a written withdrawal request for his claim. The false claim was made in 2024. After gathering evidence, the TPA officials had registered an FIR at Gandhigram police station here on Thursday.