Physio banned after Keoghs investigation

0

Physiotherapist Adeyinka Adeshina has received an 18-month ban following a Keoghs and Mulsanne Insurance Company investigation into claims he treated a personal injury patient over the phone.

The Healthcare Professions Tribunal Service (HCPTS) banned Adeshina from practising physiotherapy—a decision that it will review later this year—after the joint investigation discovered that 11 sessions of physiotherapy had been performed over the phone, via the claimant’s mother and an interpreter.

Keoghs and Mulsanne Insurance referred the case to the HCPTS, which, in its decision, dismissed Adeshina’s arguments that he had delegated the treatment to another unidentified therapist and that the method of treatment was common practise.

The HCPTS ruled: “[If 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.”

The investigation arose from a single vehicle incident that 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.

Paul Twilley, claims director at Mulsanne Insurance, said: “Mulsanne has a robust anti-fraud process overarching our claims team which deals with Ministry of Justice 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 the Keoghs healthcare-enabled fraud team, added: “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and we are delighted that Mulsanne alerted us in this case, resulting in a satisfying decision at tribunal plus a withdrawn head of claim.”

Share.

About Author

Mark Dugdale is the editor of Claims Media. Mark welcomes articles, letters or feedback from readers and can be reached via mark.dugdale@barkerbrooks.co.uk