Our Expertise

Healthcare Fraud

Key Contact

Matthew  Ruck

Matthew Ruck


T:01204 678672

The Healthcare Enabled Fraud Team is committed to helping its clients combat claims layering via medical professionals by providing intelligence, validation, investigation services and practical claims handling guidance together with the development of overarching strategies.

We have a thorough understanding of the requirements of expert medical evidence and the duties of those who seek to give expert evidence in civil proceedings and combine this with the use of relevant literature, care pathways and clinical guidelines to assess and, where necessary, challenge the opinions, competency and methodology of those experts. The aim is to reduce claims costs, change behaviours and uncover poor practise or outright fraud.

Keoghs has uncovered a large number of cases where medical reports have been produced in doctors’ names without their knowledge or where reports have been amended without their consent. This appears to be widespread across the industry and a “copy and paste” culture along with the electronic production of medical reports provides the perfect opportunity for the fraudster.

Medical professionals are also the enablers whose referrals open up the way for medical treatment costs. Over several years, the industry has seen an increase in the cost of treatment claims; in particular for physiotherapy and CBT. Keoghs seeks to assist its clients in investigating and challenging these treatment claims to reduce or defeat entirely such claims and we have also uncovered incidences of completely fabricated claims sometime with the assistance of healthcare professionals.

Where healthcare professionals are implicated by way of poor practise or knowing involvement, Keoghs will assist its clients to pursue appropriate sanctions; whether civil, criminal or regulatory.