CHIANG MAI – Central Investigation Bureau police (CIB) executed court warrants in a case involving fake medical certificates used to claim COVID-19 insurance payouts. The suspects face fraud charges.
According to police, the suspects allegedly said an insurance agent contacted them, encouraged claims, and offered to split the payout.
On 9 Oct, Highway Police, working with Subdivision 4 of the Economic Crime Suppression Division, arrested Mr Saharat, 47, and Ms Kulthida, 41. The pair, from Bang Bua Thong in Nonthaburi, were stopped on a road in Moo 3, Choeng Doi, Doi Saket, Chiang Mai.
Both are accused of fraud, forging documents, using forged documents, and making dishonest claims under an insurance policy, including submitting false evidence.
A major insurance company had filed a complaint, stating that policyholders claimed COVID-19 illness benefits using forged paperwork. The company said it had paid out to 14 claimants, with total losses of more than 12 million baht.
The insurer later checked with the clinic named on the medical certificates and found the documents were fake. Police were notified, and the court issued arrest warrants.
Investigators learned that one insured person was travelling by a white Mitsubishi sedan with Bangkok plates on the road in front of the Choeng Doi Subdistrict Municipality in Moo 3. Officers moved in and made the arrest. Both suspects admitted they were the people named in the warrants and said they had not been arrested before.
In initial questioning, they said they had valid policies with the insurer, paying 599 baht per month during the COVID-19 outbreak. They said someone claiming to be an agent offered to handle a claim in exchange for a cut of the payout.
They agreed and claimed they did not know the documents sent to the insurer were forged. Officers handed them to investigators at the Economic Crime Suppression Division for legal action and further enquiries.
Insurance Fraud and Health Insurance in Thailand
Insurance fraud is a serious problem in Thailand, especially in health insurance. It weakens insurers’ finances and pushes up costs for honest customers. Health insurance fraud happens when people or groups mislead an insurer to gain money they are not entitled to.
In Thailand, this includes fake medical claims, inflated symptoms, collusion with clinics to pad bills, or claims for care that never happened. Economic pressure, light oversight, and social tolerance for small cheats all play a part.
Thailand’s health system mixes public and private care. Citizens have access to schemes such as the Universal Coverage Scheme (UCS). Private health insurance serves many expatriates, higher‑income residents, and anyone seeking faster access or premium services.
Private cover is attractive for shorter waits and modern facilities, but it also attracts fraud. Some clinics overcharge for procedures or list unnecessary treatments to raise payouts. Some patients try to pass non‑medical costs off as medical bills.
The state and the industry have moved to curb abuse. The Office of Insurance Commission (OIC) oversees the market and requires insurers to run anti‑fraud controls. These include claim reviews, audits, and data analysis to spot unusual patterns. Problems remain due to limited enforcement capacity and the difficulty of probing cases across many small clinics. Public campaigns try to explain how fraud feeds higher premiums and damages trust.
Insurers are adding new tools to fight back. Many use AI to flag irregular claims and compare billing patterns. Some work more closely with hospitals to improve itemized billing and price transparency.
Stronger rules, better protection for whistleblowers, and clear ethics in provider practice would reduce fraud risks and support a stable market for health insurance in Thailand. For policyholders, the message is simple. Read your policy, keep accurate records, and report concerns. Honest claims keep premiums fair and help keep health care accessible for everyone.
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