The State Vigilance and Anti-Corruption Bureau (SVACB) booked Dr Nand Lal Kaundal, owner of the Apna Aspatal at Ghagas, in connection with a “health insurance racket”. But the SVACB has yet to go to the bottom of this “multi-crore racket” as more than 22 private hospitals are empanelled under the Rashtriya Swasthya Bima Yojna (RSBY) in the state.

After establishing the prima facie evidence, the SVACB today lodged an FIR against Kaundal at the vigilance police station in Bilaspur charging him of cheating, criminal breach of trust and criminal conspiracy. He runs two more hospitals at The Ridge, Shimla, and Baddi in Solan, which are under the Vigilance scanner, sources revealed.

The hospital allegedly created fake files of over 125 patients belonging to the Below the Poverty Line (BPL) and Integrated Rural Development Programme (IRDP) families and claimed Rs 2.5 lakh under the RSBY in 2011. Besides, the hospital also showed the same in case of 55 BPL patients till February 2012, the vigilance probe found.

Virender Sharma, Superintendent of Police, Vigilance, Central Range, said they had lodged an FIR and further investigation in the case was on. The hospital not only created fake files of patients to get insurance claims worth Rs 5.85 lakh, but had also conducted fake lab tests on patients who were never admitted to the hospital, he added.

As per inputs gathered, New India Insurance company, a Government of India undertaking, has released Rs 2.5 lakh to the hospital out of the Rs 7.5 lakh claimed by the Apna Asptal.

There are over 22 private hospitals empanelled by the state Health Department allegedly on pick-and-choose basis. As many as eight private hospitals in Kangra, two each in Shimla and Una, one each in Kullu, Chamba, Bilaspur and Sirmaur districts and four private hospitals in Solan district and other hospitals are represented by the Health Minister, sources revealed.

KC Sadyal, Additional Director-General, SVACB, said they had yet to get the facts at hand in connection with the case. Mohan Singh, senior manager, NII, said the company had paid Rs 4 crore out of Rs 22 crore paid as total claims submitted by the hospitals to the company till January 2012.

“We have received Rs 32 crore as premium under the RSBY — 75 per cent contributed by the Centre and 25 per cent by the state,” he added.

Article is taken from the Tribuneindia online edition.