The Public Prosecutor’s Office of the Dominican Republic has launched an investigation that points to affiliates of the National Health Insurance (SENASA) as victims of an alleged identity theft and signature forgery operation. The investigated individuals, who are located in various regions of the country, claim they have not received the medical services that appear recorded under their names in the claim forms.
Testimonies that baffle the health system
According to data gathered by the prosecutor’s office, the interviewed affiliates stated they do not know the doctors listed in the documents, nor the diagnoses and procedures recorded. They also insisted that they never visited the medical centers or clinics where the authorizations are recorded.
Dates and locations that do not match
- Some respondents claimed that, on the dates and times when they supposedly received medical care, they were at their workplaces.
- Others asserted they were at home, out of town, or even abroad when it was reported that consultations or procedures had been performed in their names.
- A few did not know either the existence or the location of the centers where they were allegedly treated.
Selection of affiliates by location and usage frequency
The accusation holds that the defendants chose individuals with diverse profiles, residing in different parts of the country and with low frequency of insurance use. According to the Public Prosecutor’s Office, this strategy would allow affiliates not to detect the misuse of their data.
Signs of a planned operation
The Public Prosecutor’s Office file interprets the pattern of testimonies as evidence of an operation that would have used privileged information, identity theft, and signature forgery to generate claims against SENASA without the affiliates’ knowledge. The prosecutor’s office continues gathering evidence to determine the scope of the scheme and possible third‑party involvement.
Source credits: n.com.do
