Health Insurance Counter Fraud Group UK Forum HICF Group, About

The Health Insurance Counter Fraud Group was commenced in July 2001 by a number of large insurers. There was little awareness of health care fraud in the UK until about 2000.  

In 2000, the National Health Service (NHS) Counter Fraud and Security Management Services began highlighting cases of fraud and obtaining prosecutions. The goal back then remains the same today – to prevent and detect fraud within health care.  

The group met originally to discuss issues of common interest and to exchange information and suspicions about potential frauds under an agreed terms of reference. Initially, Aviva (Norwich Union) and AXA PPP health care conducted joint investigations, but cooperation soon increased as it became apparent that the same fraudsters were being identified scamming multiple companies, often at the same time. As a result of collaboration and sharing of intelligence, cases have been presented to both criminal courts, General Medical Council, and other professional bodies. Civil redress and criminal convictions have been obtained by health insurers. This can be attributed to the coordinated efforts of the industry to stamp out fraud.  

In 2011, the HICFG in co-operation with the National Health Care Anti Fraud Association USA (NHCAA),Canadian Health Care Anti Fraud Association (CHCAA), European Health Fraud and Corruption Network (EHFCN), and Healthcare Forensic Management Unit South Africa (HFMU) commenced a global association known as the Global Health Care Anti-Fraud Network. This saw the partnering countries and regions signing the GHCAN MOU. For further information on this important alliance please visit: www.ghcan.net.

  In 2012, the HICFG (in partnership with the Association of British Insurers) is subscribed to by over 30 health related insurance companies - including the ten largest private medical insurers. The membership includes serious and critical illness insurers, re-insurers, international, health-related, expat insurers, and cash back health insurers. The HICFG provides members a technical platformin which to share intelligence in order to prevent and detect fraud within health care.  

The HICFG also offers an accredited training course, holds an annual conference, and provides its members with bespoke technology specific to the industry.  

The HICFG works closely with its domestic partners, National Health Service Protect (NHS) sharing a Memorandum of Understanding (MOU). This is replicated with NHS Counter Fraud Scotland and NHS Counter Fraud Northern Ireland. The HICFG holds a relationship with the Insurance Fraud Enforcement Department and National Fraud Authority, City of LondonPolice, Insurance Fraud Bureau, and the Insurance Fraud Investigators Group to facilitate the cycle of intelligence and undertake joint investigations into fraud. The HICFG has formal relationships with health Anti fraud associations in the U.S.A, Europe, Canada, Persian Gulf, Australia, Middle East, South East Asia and South Africa. Health care fraud knows no borders.

  Last year, the HICFG successfully hosted the second annual Global Health Care Anti-Fraud Network summit. It included 220 delegates from 23 different countries. If your company is interested in membership, associate membership or vendor membership with the Health Insurance Counter Fraud Group, please contact us at: www.hicfg.com.