Many dentists are offering expensive treatment plans that their patients do not need, in fraud that is pushing up the cost of health cover, insurers say. They say abuse of insurance is systematic and all too common in dentistry, with some practitioners obtaining approval for procedures that are covered, such as fillings, but using the money to pay for cosmetic treatments that are not.
“This is common in dentistry, with unnecessary replacement of fillings, for example, for cosmetic reasons,” said Mark Adams, chief executive of Anglo Arabian Healthcare. One of the most common tactics to take advantage of the system is planning treatment in advance, said Dr Sherif Mahmoud, regional head of health insurance at AXA Gulf. Using money from approved treatment for cosmetic procedures was a win-win situation for the dentist and patient, but it will drive up the cost of insurance as insurers pay out more. “There is no guarantee the insured would continue treatment until the end of the plan,” Dr Mahmoud said. An oversupply of dentists has led to enormous competition, and some clinics fear they will not survive unless they cheat the system, insiders claim.
Dr Benjamin Samuel, a dentist at Medeor 24×7 Hospital in Dubai who has been in the UAE for eight years, said he was aware of such dubious practices. “I’ve worked with many dentists here and I’ve heard that this goes on but not from immediate colleagues,” Dr Samuel said. “It is harder to get away with now because there are more internal and external audits from insurance companies, so it is risky to play around with insurance but I’ve heard that this has been going on.
“We are at saturation point as there are so many dentists in Dubai from all over the world. The prices are high and most insurance policies won’t fully cover all dental procedures. “People don’t want to spend money from their own pocket on dental work, so they do unscrupulous things instead.” […]