Expense Fraud | Expense Claims Fraud in Berlin

In 2014, according to the respective statistical offices, only Baden-Württemberg experienced stronger economic growth than Berlin, primarily due to a significant increase in Berlin’s construction sector. In the same year alone, 40,000 (!) new workers arrived in Berlin, providing the necessary “manpower” to establish a solid foundation for growth potential and opening up further market opportunities, particularly in the construction industry (keywords: housing shortage and transport infrastructure).

 

A large number of employees, however, also means a greater potential for breaches of employment contracts and labour law. In Berlin’s vast service sector and rapidly expanding construction industry, many employees work in the field with more or less flexible hours. For employers, it is always challenging in such scenarios to verify whether employees are completing the contractually agreed work fully and diligently. When doubts arise, commissioning detectives such as those at Kurtz Detective Agency Berlin is often the only solution: +49 30 5557 8641-0.

Trust alone is often insufficient – Verification by Detectives

The relationship between field staff, drivers, contractors, and other company employees and the employer is based on trust. Lack of supervision and the relative independence of these groups may tempt some individuals to shift private expenses onto the company – car repairs for a daughter billed to the company car, trips to visit a grandmother, a rendezvous charged as a business meal, and so on.

 

It becomes even more serious when field staff fail to attend appointments, effectively perform no work, yet still submit full expense claims. This constitutes fraud, specifically expense fraud – a criminal offence and, over time, a significant financial burden on the business owner.

 

If you suspect that you have been a victim of expense fraud, the corporate detectives of Kurtz Detective Agency Berlin can assist. We investigate the suspect’s environment and, if necessary, observe them to provide you with certainty.

Expense Fraud in Medical Services

Few sectors are as vulnerable to bribery, corruption, fraud, and abuse as healthcare. The Association of Statutory Health Insurance Physicians (KV) now increasingly relies on plausibility checks for medical billing to detect deliberate or negligent mischarging. These routine checks have already contributed to case resolutions, yet many fraudsters naturally remain undetected.

 

When our Berlin detectives investigate expense fraud in medical billing, it usually involves deliberate fraudulent activity rather than negligent misbilling. We are only engaged once discrepancies accumulate and indicate a clear intent to commit fraud. Since intent is difficult to prove (the physician will not self-incriminate), the collection of legally admissible evidence establishing deliberate intent is essential.

 

Possible offences in medical expense fraud include:

 

• Fictitious services
• Incorrect assignment of services (misapplied billing codes)
• Full billing for only partially provided services
• Billing for fictitious patients

High-Profile Berlin Scandals

In 2013, the so-called “billing scandal” shook Berlin’s healthcare sector. Police and public prosecutors conducted 22 apartment searches across Berlin, Brandenburg, and Saxony-Anhalt in a large-scale operation against professional expense fraud in Berlin. A medical care centre (MVZ) in Charlottenburg and over 100 (!) physicians were the focus of the investigation. They allegedly billed for MRI scans without physician involvement over several years, resulting in a total loss of approximately 1.5 million euros.

 

In 2010, there were also large-scale investigations into organised medical billing fraud in Berlin. Among 62 suspects, 190 searches were carried out. The allegation concerned billing for chief physician services for specialised medical procedures carried out by assistant physicians not qualified for those tasks. In this case too, the financial damage was estimated at over 1 million euros.