Investigations by Keoghs and Mulsanne Insurance lead to 18 month suspension for physiotherapist
News And Events12/01/2018
Physiotherapy claim also withdrawn as phone sessions placed under spotlight.
Evidence provided by Keoghs and Mulsanne Insurance Company Limited has uncovered the suspicious activities of physiotherapist Adeyinka Adeshina who, as a result, has received an 18 month ban by the Healthcare Professions Tribunal Service (HCPTS).
The investigation arose from a single vehicle incident which resulted in four personal injury claims, with one claim from a 13 year old minor referred to Keoghs by Mulsanne Insurance due to concerns over alleged physiotherapy treatment.
It was stated that the claimant had undertaken 11 sessions of physiotherapy, delivered by Mr Adeyinka Adeshina, the director of Physique Rehab Ltd, following his instruction by Concise Medico Ltd. In a bizarre twist the treatment was said to have been performed over the phone, with Mr Adeshina speaking to the claimant’s mother via an interpreter. Even more curiously, the discharge report bearing his signature stated that the treatment provided included ‘Massage release’, ‘Spinal posture correction’ and ‘ice/heat- ice pack followed by heat pack 10 mins’.
Adding to suspicions, the claimant’s mother said she had no knowledge of either the treatment or Mr Adeshina when interviewed by a claims inspector. In contrast Mr Adeshina confirmed that he did undertake the alleged treatment when interviewed. The claimant’s mother later contradicted herself in court proceedings when she decided that the treatment had, in fact, taken place.
Investigations by Keoghs’ healthcare-enabled fraud team uncovered that Mr Adeshina had previously been suspended from the Health and Care Professions Council register following a conviction for possessing counterfeit currency and making off without payment. Interestingly, his suspension between November 2015 and March 2016 overlapped with two of the treatment sessions in question.
The team reported Mr Adeshina to the HCPTS, who opened an investigation and requested evidence from both Keoghs and Mulsanne.
On 29 November 2017, Mr Adeshina went before the HCPTS Investigating Panel. At this point he started to backtrack, alleging that he delegated the treatment to another unidentified therapist and also alleging that the method of treatment was common practise. Neither of these assertions were accepted by the Panel who gave the physiotherapist an 18 month suspension, stating that if Mr Adeshina;
“…believes this to be acceptable treatment, he will put future patients at considerable risk… he also presents a significant risk to other members of the public and companies dealing with the Registrant being charged for work he has not done” and that “public confidence in the profession would be undermined if the Registrant continued in practice”.
Mr Adeshina received an 18 month suspension from the HCPC register to be reviewed by 29 May 2018. The claim for the physiotherapy treatment from the claimant was, unsurprisingly, withdrawn.
Paul Twilley, Claims Director at Mulsanne Insurance Company Limited said;
“Mulsanne has a robust anti-fraud process overarching our claims team which deals with MOJ whiplash claims, this process subjects all claims for physiotherapy to a tiered structure of validation thus capturing high risk claims for investigation. This identification, and subsequent thorough investigation which has taken place utilising field inquiries conducted by our partners The Brownsword Group, has resulted in valuable evidence being gathered. The subsequent work undertaken by Keoghs on our behalf has ultimately resulted in the professional enabler involved being brought to task by the appropriate regulatory body and this is a very pleasing result.”
Matthew Ruck, strategy lead for Keoghs’ healthcare-enabled fraud team, stated;
“There is no doubt that claims layering via medical professionals is a large problem when dealing with insurance fraud. Whether they are enabling or instigating, it is vital that the industry takes a close look at suspicious treatments and we are delighted that Mulsanne alerted us in this case, resulting in a satisfying decision at tribunal plus a withdrawn head of claim.”