[News] $ 500 billion lost to 'phantom' traffic accidents

[Akrapovic]

The Comptroller's Office identified spoofed identities, false accidents, and orthopedists and IPS interested in keeping most of the resources.

 

 

The Comptroller General of the Republic, through the Directorate of Information, Analysis and Immediate Reaction (Diari), revealed that 500,000 million pesos are committed for allocations to 'ghost' traffic accidents, that is, without real patients, which the State covered and financed through the Administrator of the Resources of the General System of Social Security in Health (Adres).

These monies were drawn between January 2018 and May 2021.

(See: Covid-19, the worst claim that the insurance industry has faced).

The Comptroller's investigators established that the State financed 13% of 2,384,559 accidents, that is, resources were allocated for 314,074 events.

The control entity found that 44% of the money transfers for this purpose were collected by only eight IPS, which represent 1% of these health providers at the national level. These clinics are located in Valle del Cauca, Córdoba, Magdalena and Cesar, and have obtained more than 239,000 million pesos for patients who suffered accidents.

The Comptroller's Office found the record of a patient who allegedly had 20 accidents in two years in which Soat never had, so Adres covered her cats.

(See: Approve reduction in the cost of Soat for those who do not use the policy).

According to data from the Cali IPS, the man had an accident for 5 days in December 2019 and, in 2020, eight times. During 2021, there are two events. Through these procedures, 3,087,324 pesos were approved.

In the cases, the accident vehicle was never identified, nor its respective policy, which raised suspicion on the Comptroller's Office.

The same happened with a man who had an accident for four years without having his insurance policy. And it was stated that the man suffered 15 accidents, in which he had eight injuries to the wrist, hand, ankles, spine, feet and elbows.

THE DECEASED WHO COLLECTED MONEY

Another of the irregularities found by the Comptroller's Office was that of patients who had already died, but appeared within the collections.

(See: This is what happens to the debts of a person who has passed away.)

The control body identified 15 people who died before the date on which they allegedly had an accident. The resources destined for these services add up to more than 129 million pesos.

On the other hand, there are registered people who were paid their medical expenses, but their identity is not known.

Likewise, the investigation revealed that two orthopedists charged more than 25,000 million for treating, supposedly between them, 27,921 patients due to accidents. One of the doctors, in 42 months, would have provided his services to 16,254 injured, for which the administrator paid more than 6,200 million pesos.

"This figure is impossible, since this doctor would have to work exclusively eight hours a day, from Monday to Sunday, without rest 365 days a year to receive an average of 13 injuries," explained the Comptroller.

The other orthopedist treated 11,667 injured by traffic accidents in eight departments of the country. Therefore, 19,000 million pesos were approved, which the specialist registered. According to the control body, the doctor would have had to treat 55 injured a day.

(See: Cities where more insurance money will be paid for damages during unemployment).

The Comptroller's Office also warned about accidents that hoarded resources when patients did have Soat. These three cases occurred in Montería (Córdoba) and Neiva y Garzón (Huila). According to the authorities, the same claim was paid twice.

BRIEFCASE

 

LINK: https://www.portafolio.co/economia/finanzas/contraloria-publica-irregularidades-en-cobros-de-soat-y-adres-por-accidentes-de-transito-557761