Mumbai: Rs 10.21 Lakh Health Insurance Fraud Case Registered Against Four, Including Two Doctors in Nalasopara

Mumbai, 3rd August 2026: Pelhar Police have registered a criminal case against four individuals, including two doctors associated with Galaxy Hospital in Nalasopara East, for allegedly defrauding an insurance company through fake health insurance claims worth ₹10.21 lakh.

The accused have been identified as Pooja Khan, who manages Galaxy Hospital, Dr. Gaurav Sharma, Dr. Imran Khan, and Rajneesh Hoshiyar Singh. The case was registered following a complaint filed by Chetan Nandu Chavan, Branch Operations and Service Manager at Bajaj General Insurance Limited.

According to the complaint, the accused allegedly submitted forged medical records, fabricated signatures, and false treatment documents in the names of patients who had reportedly not received treatment at the hospital. These fraudulent documents were used to obtain health insurance claim settlements from the insurance company.

The alleged fraud came to light after Bajaj General Insurance’s Investigation and Loss Mitigation Department flagged several suspicious claims. A detailed audit conducted by Garuda Healthclaim Services examined health insurance claims filed between 2024 and 2026 and found serious irregularities in 17 claims.

During the audit, Dr. M. P. Rao, whose name appeared as the treating doctor in the claim documents, reportedly stated that he had not treated any of the 17 patients. Investigators also found discrepancies in the signatures of the pathologist on blood and urine test reports, raising further suspicion that the medical documents had been forged.

Police said that based on these 17 fraudulent claims, ₹10,21,920 was transferred by Bajaj General Insurance to the hospital’s account. The complainant has alleged that the accused acted in collusion to prepare forged documents and secure wrongful financial gains.

A case has been registered under relevant provisions of the Bharatiya Nyaya Sanhita (BNS), including Sections 61, 318(4), 336(2), 336(3), and 3(5). The investigation is being led by Police Sub-Inspector Sachin Ubale of Pelhar Police Station.

Police are now expanding the probe to determine whether similar fraudulent claims were submitted to other insurance companies and whether a larger insurance fraud racket is involved.