SOUTH DISTRICT Dated: 15.06.16 Ø Gang of cheats busted : Kingpins ofthe gang along with 5 associates arrested. Ø Gang is involved in getting thesanction of medical claims of corporate employees from United India InsuranceCompany on the basis of forged medical papers. Ø Gang members have got sanctioned 66forged medical claims for Rs. 56 Lacs. The team of PS R.K. Puram, South District have busted a gang of cheats andarrested kingpin of gang along with 5 associates. Gang was involved in getting the sanction ofmedical claims of corporate employees from United India Insurance Company onthe basis of forged medical papers. Accused arrested : 1. Vishal Gupta, age 40 years s/o Jagdish Prasad Gupta r/o F-300, VikasPuri, Delhi (Kingpin of the gang). 2. Ganesh Kumar, age 32 years s/o Vishnu Dev Yadav R/o H No RZ-D-1A/128-C,Gali No. 5, Mahavir Enclave, Delhi. 3. Dr Pankaj Bhardwaj, age 28 years s/o Ram Kishan R/o H No 2010, Sec-4,Gurgaon, Haryana. 4. Deepak Sharma, age 38 years s/o Late Madanlal Sharma R/o H No RZ-I-92,Gali No 6, West Sagarpur, Delhi. 5. Amit Kumar, age 22 years s/o Vijaypal R/o H No D- 2/5, IV Floor, VashishtPark, Janakpuri, Delhi. 6. Nikunj Kumar, age 25 years s/o Ram kishor Prasad R/o H No RZ 58/210, JBlock, West Sagarpur, Delhi. Brief facts: The complainant Mr. R. Subramaniyum,Director M/s Vipul Med Cap, TPA Pvt Ltd, situated at Bhikaji Cama Place filed acomplaint alleging therein that some persons have cheated their company of Rs.56 Lacs on the basis of false medical claims. The company found that in the months of March and April, 2016, there wasa sudden increase in medical claims. Hence,the company decided to investigate the authenticity of medical claims. During internal enquiry, it was found that 33medical claims were bogus and manipulated and an amount of Rs. 28,17,320/- wasencashed fraudulently. Later on, 2 morecomplaints were received from the said company regarding fake medical claimswherein the company had cleared the medical bill of around Rs. 30 lacs. After verifying the facts, a case vide FIRNo. 312/16 dated 11.06.16 u/s 420/468/471/120 B IPC was registered at PS R.K.Puram and investigation taken up. Investigation: During investigation, the facts offorged medical claims were also verified from the employees of company M/sLuminous Power which revealed that no-one had applied for any such medical claim. The medical claim bills provided withcomplaint were also verified from the concerned hospitals and the same werefound forged. The details of accounts inwhich the alleged amount was transferred were also obtained and verified. Account statements were analyzed whichrevealed that major transactions had taken place from United Insurance Companyin the accounts of Deepak Sharma and Amit Kumar. In orderto arrest the culprits involved in such criminal activities, two teams headedby Inspr. Neeraj Chaudhary and Inspr. Vijaypal Dahiya consisting of SI S.K.Singh, SI Vijay Kaushik, SI Surender Rana, ASI Rakesh Kumar, HC Gulab Singh, HCSanjeev, HC Naim, HC Sukender, HC Ritesh, Ct Prashant and Ct manoj, CtPrashant, Ct Ajit Punia, Ct. Anuj and Ct. Praveen under the supervision of Sh.S.P. Tyagi, ACP/S.J. Enclave were formed. Duringinvestigation, the account holders where big amounts were transferred wereidentified as Deepak Sharma, Proprietor of M/s Hi-Tech Power Solutions, West Sagarpur,Delhi (deals in inverters and batteries) and Amit Kumar R/o Janak Puri, Delhiand third accomplice namely Nikunj Kumar who played as a conduit between Deepakand Amit and other gang members were arrested. Interrogation : During interrogation, it wasrevealed that accused Deepak Sharma is an authorized dealer of Luminous Companyand runs a shop in the name of Hi-Tech Power Solution and deals in Luminous Inverter& Battery since 2005. The Engineersof Luminous Company after attending the complaints of customers used to visitthe shop of Deepak Sharma and deposit service cum repair charges and their IDdetails with Deepak Sharma, who maintains a register for this purpose. AccusedNikunj Sharma used to work with with a company in Noida, UP and provide cashlessfacility to medically insured persons. Heleft his job in year 2015. Later, hecame in contact with one Ganesh, who was working as Tax and Insurance Agent cumAdviser in Insurance Company. He told Nikunj Sharma that Vipul TPA Pvt. Ltd.has authorization of sanctioning the amount of medical claim of the employeesand he has good links in the company. Hefurther told that he can forge the medical claim bills of the employees and canget the amount sanctioned fraudulently. Hegave him lucrative offer to earn handsome money if he would procure him medicalclaim cards of the employees of Luminous Company. NikunjSharma roped Deepak Sharma and Amit Kumar in his net and planned the procedure andtheir share in each transaction. DeepakSharma informed them that he can easily provide the details and ID of employeesof Luminous Company which are maintained by him being authorized dealer ofLuminous Company. Deepak Sharma and Amit Kumar also provided their bank accountnumbers to Nikunj Sharma for transferring the amount. Aftergetting the ID and details of employees, accused Nikunj and Ganesh used to sendmail in the Customer Care of Luminous Company to collect the details of medicalclaim card of employees. Accused Ganesh through his sources gets the medical claimscleared and transfer the amount in the accounts of Deepak and Amit Kumar. AccusedDeepak and Amit Kumar after retaining their share, transfer the remaining amountin the account numbers of other associates. Policecustody remand of accused persons was obtained and at their instance, otheraccused persons namely Ganesh Kumar and Vishal Gupta were also arrested. Duringinterrogation of both accused persons, it was revealed that accused Ganesh has earlierworked as agent in insurance sector since 2002. In year 2013, he came in contact of VishalGupta who used to work as property dealer and Insurance Agent, etc. Vishal Gupta roped him in the net of his knownDr. Pankaj Bhardwaj, Head of Medical Claim Processor in Vipul TPA Pvt. Ltd. On13.06.16, Dr. Pankaj Bhardwaj was arrested in the case. During interrogation ofaccused Dr Pankaj Bharadwaj, it was revealed that on the instance of accusedVishal Gupta, Ganesh and his associate Deepak Sharma used to procure the employeemedical card, copy of cheque and copy of ID proof to Dr Pankaj Bhardwaj. Dr Pankaj Bharadwaj being the Head of Claim Processerof complainant’s Company had easy access over the documents division andcomputer system in the company and easily obtain / download the original claimsin his personal laptop and after forging the name and other details managed tosanction the medical claims. Profile of accused persons : 1. Vishal Gupta, age 40 years s/o Jagdish Prasad Gupta r/o F-300, VikasPuri, Delhi (Kingpin of the gang) is B. Com.. He deals in propertyand insurance. He is married and has twochildren. He gets 15 to 20% commissionfor each medical claim. 2. Ganesh Kumar, age 32 years s/o Vishnu Dev Yadav R/oGali No. 5, Mahavir Enclave, Delhi is BBA. He is married and has one child. In year 2002, hecame to Delhi and started working as agent in insurance sector. He gets 15 to20% commission for each medical claim. 3. Dr Pankaj Bhardwaj, age 28 years s/o Ram Kishan R/oH No 2010, Sec-4, Gurgaon, Haryana is Bachelor in Ayurvedic Medicine andSurgery (BAMS). He ismarried. He gets 30% commission for eachmedical claim. 4. Deepak Sharma, age 38 years s/o Late Madanlal SharmaR/o Gali No 6, West Sagarpur, Delhi has studied upto 10th class. He runs an Inverter and Battery Shop atSagarpur in the name of Hi-Tech Power Solution since 2005. He is also authorized dealer of LuminousInverter Company. He is married and hastwo children. He gets 10 to 15% commissionfor each medical claim. 5. Amit Kumar, age 22 years s/o Vijaypal R/o H No D- 2/5, IV Floor, VashishtPark, Janakpuri, Delhiis BCA. He is native of VillageKushalpur, District Meerut, UP. He runsa company in the name and style of Web Intelligence since 2013. He is unmarried. He gets 10 to 15% commission for each medicalclaim. 6. Nikunj Kumar, age 25 years s/o Ram Kishor Prasad R/o J Block, WestSagarpur, Delhiis BBA. He is native of Gandhi Nagar,Asiana Nagar, Patna, Bihar. 7. Recoveries : 1. One note book maintained by accused Deepak containing thedetails and IDs of employees of Luminous Company. 2. 10 mobile phonesused in commission of crime. 3. 3 laptops and 2 printersused in commission of crime. 4. 11 rubber stampsused in commission of crime. 5. The accounts of accusedpersons having the cash Rs. 10.75 lakhs have been freezed. Furtherinvestigation of the case is in progress and efforts are on to probe in otherinvolvements of accused persons. (Ishwar Singh), IPS DCP/South District

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