蘑菇视频DT/2023/034, YAGOUT
There was clear and convincing evidence that the Applicant engaged in entitlement fraud and received reimbursement for medical services that had not occurred. He falsely certified and submitted three Cigna claims; for which he was paid a total of USD17,171.26. He was not entitled to this reimbursement. As 蘑菇视频DP is self-insured, these funds represented a loss to 蘑菇视频DP.
The Applicant’s behaviour fell within what the 蘑菇视频DP Policy against Fraud and other Corrupt practices (approved in October 2018) defines as fraud. The established facts constituted misconduct.
As to proportionality of the...