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Could I get done for fraud?

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Rodger
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2005/08/04 15:30:39 (permalink)
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Could I get done for fraud?

Been to see GP about getting refered to specialist and get a MRI scan on my shoulder, still getting problems with it since dislocating it May 2004. I told her I have some Healthcare Cover through work and what was the procedure etc?

She asked me how I did it and told her, just like i had to tell the hospital (NHS) when i first did it (basically my brother got out of headlock i had him in and and my shoulder was left dislocted....).

So, I rang the Health carepeople, and thinking I wouldnt have a claim if i said i was scuffling, I said I fell. Now thats on bloody telephone recording too.

If the claim goes through and i get treatment/scan paid for my insurance company, because I've got on record on doctors file I did it whilst scuffling, could i end up in trouble.

Should have done this first, but read the exclusions in rems and condition on policy and it doesnt mention fighting.

Now i dont lie but I didnt think i'd have a chance if I said how it really happened.

Is there a chance?

Injured!!

Squat 170kgx1 105kgx25
Dead 200x1
Decline Bench 80x6

Formerly BencherRdg  (what a stoooopid name!)
#1

14 Replies Related Threads

    Rodger
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    RE: Could I get done for fraud? 2005/08/04 16:08:43 (permalink)
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    anyone?

    Injured!!

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    Formerly BencherRdg  (what a stoooopid name!)
    #2
    Rodger
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    RE: Could I get done for fraud? 2005/08/04 16:08:43 (permalink)
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    post edited by BencherRdg - 2005/08/04 16:09:33

    Injured!!

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    Dead 200x1
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    Formerly BencherRdg  (what a stoooopid name!)
    #3
    Rodger
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    RE: Could I get done for fraud? 2005/08/04 16:08:44 (permalink)
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    post edited by BencherRdg - 2005/08/04 16:09:08

    Injured!!

    Squat 170kgx1 105kgx25
    Dead 200x1
    Decline Bench 80x6

    Formerly BencherRdg  (what a stoooopid name!)
    #4
    DonVito
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    RE: Could I get done for fraud? 2005/08/04 16:15:43 (permalink)
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    just say they misunderstood you . say about your brother and a head lock then say you fell after.. lie through your teeth mate. i dont think there would be a problem..

    "Oh!! Thats your Boyfriend, i thought you were tallking your little brother for a walk.."
    #5
    REALLYFIT
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    RE: Could I get done for fraud? 2005/08/04 16:22:49 (permalink)
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    No mate you will be fine. Just look at the policy exemptions on your policy. There is bound to be one relating to a material non-disclosure that is that you failed to disclose when questioned the exact nature of your injury and how it occured. Like DonVito said just bend it to fit the truth. With medical issues contributory negligence is always a factor but in this case it was a genuine accident. Examples that insurance companies would pull cover on include driving whilst drunk or without a seatbelt etc this is true contributory negligence a scuffle that ended in an injury wouldn't be classed as being such and if they argued that it was I am sure either the FSA or insurance ombudsman would have something to say in support of your case.
    #6
    Rodger
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    RE: Could I get done for fraud? 2005/08/04 16:26:56 (permalink)
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    ORIGINAL: DonVito

    just say they misunderstood you . say about your brother and a head lock then say you fell after.. lie through your teeth mate. i dont think there would be a problem..


    i'm not one to lie, but in this instance i'm going to have to. The amount of spongers and criminals etc in this coutry, and i'd normally not tell a lie at all.

    I'll just have to do that, wish i'd mentioned the scuffle then fall (there wasnt really a fall) I may on my feet the whole time i think

    Injured!!

    Squat 170kgx1 105kgx25
    Dead 200x1
    Decline Bench 80x6

    Formerly BencherRdg  (what a stoooopid name!)
    #7
    Rodger
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    RE: Could I get done for fraud? 2005/08/04 16:31:37 (permalink)
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    ORIGINAL: REALLYFIT

    No mate you will be fine. Just look at the policy exemptions on your policy. There is bound to be one relating to a material non-disclosure that is that you failed to disclose when questioned the exact nature of your injury and how it occured. Like DonVito said just bend it to fit the truth. With medical issues contributory negligence is always a factor but in this case it was a genuine accident. Examples that insurance companies would pull cover on include driving whilst drunk or without a seatbelt etc this is true contributory negligence a scuffle that ended in an injury wouldn't be classed as being such and if they argued that it was I am sure either the FSA or insurance ombudsman would have something to say in support of your case.


    ok cheers mate, that does fill me with confindence

    Injured!!

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    Dead 200x1
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    Formerly BencherRdg  (what a stoooopid name!)
    #8
    TooSmall
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    RE: Could I get done for fraud? 2005/08/04 17:22:52 (permalink)
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    You were mucking about with your brother, then turned to walk away and fell.

    Wouldn't worry at all.

    Forget Elvis, Arnie is the king.

    #9
    Rodger
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    RE: Could I get done for fraud? 2005/08/04 17:32:46 (permalink)
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    it sounds simple to explain now, but Health insurance have it on record (ie phone call)that "I Fell". Not sure whats on my reord at doctors, but I told the GP today I had a little scuffle (cant even remember if I mentioned the headlock).

    When i went to A&E I think i told them (embarassingly i had brother in a headlock and he got out - tking shoulder out of joint with it)

    Hightly embarassing as he's only 18, and a skinny lanky b*gger

    Injured!!

    Squat 170kgx1 105kgx25
    Dead 200x1
    Decline Bench 80x6

    Formerly BencherRdg  (what a stoooopid name!)
    #10
    sootybaby
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    RE: Could I get done for fraud? 2005/08/04 17:57:59 (permalink)
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    Sell your soul if necessary, just get them to pay for the scan and hopefully any other treatment. The insurance companies are usually concerned most with pre-existing injuries that are not covered by the policies. However, when you get to see the consultant it is amazing the way they can manipulate systems to your advantage.
    #11
    YumPies
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    RE: Could I get done for fraud? 2005/08/04 18:10:20 (permalink)
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    ORIGINAL: BencherRdg
    The amount of spongers and criminals etc in this coutry, and i'd normally not tell a lie at all.


    Mate indirectly you are sponging, off of your insurance company. Your telling a lie to pay for something which you should be paying for yourself.

    Anyhow, Did you check the whole policy and sure it doesnt cover this? Just blag it.
    #12
    alpine
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    RE: Could I get done for fraud? 2005/08/05 00:40:43 (permalink)
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    Look, these insurance companies will have no quarms about letting some child die of cancer by refusing expensive treatment if they could get away with it without any publicity.

    So I wouldn't bother about it too much apart from the fact you have made a full and frank confession about your crime on the world wide interweb.
    #13
    AndyGates
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    RE: Could I get done for fraud? 2005/08/05 11:51:04 (permalink)
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    Blag it. You'll be fine. But don't kid yourself that you're not now one of those criminals and scroungers.
    #14
    cliff_vtr
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    RE: Could I get done for fraud? 2005/08/05 12:07:22 (permalink)
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    There is no one that can disprove what you are saying is there.

    I just claimed physio for my back under my healthcare and one question was "how long have you had this problem". I wrote down 5yrs or so, my physio said to change it as the claim may not get accepted, so I tipexed it out and put 2weeks. If you look closely you can see what was there before but the claim has gone through no probs.

    Like others have said "you had a play fight with your brother and then fell down the stairs after."

    Paul
    #15
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