Durban – A Durban pharmacist has laid charges of intimidation and extortion against the country’s biggest medical aid scheme Discovery Health.
Previsha Harripershad claims that Discovery officials tried to extort over R1million from her in 2013 by falsely accusing her of making fraudulent claims from the medical aid.
This week, Harripershad decided it was time to pursue criminal action.She said she was also in the process of opening a case with the public protector.
Harripershad, who previously owned three pharmacies in Durban but now only has one, said the medi- cal aid had crippled her business by accusing her of a crime she did not commit.
She claimed that Discovery forensic officials coerced her into attending a “routine” meeting in 2013 about a medical aid claim she made.
Harripershad was pregnant at the time and the officials assured her the meeting was “nothing serious”.
Harripershad wanted her attorney to be present and asked for a rescheduled meeting, but the officials apparently said it was not necessary.
“When I went to their offices in Joburg with my husband Ravesh, they took us to a secured room. After having a general discussion, they placed a piece of paper on the table and said I was accused of fraud related to an irregular transaction,” claimed Harripershad.
She said she was baffled and could not recall the transaction they referred to. The transaction amount was just over R1600.
She was allegedly told that two Discovery officials with spy came-ras had visited her pharmacy and recorded the fraudulent transaction in question.
“I asked if I could call the pharmacy to verify the claims as I was on maternity leave at the time, but they refused.
“The officials then took out an acknowledgement of debt agreement for R1m and said we had to sign it if we didn’t want action taken against us.
“We asked if we could consult with our attorney first because we were shocked at the R1m figure, but one of the officials began raising his voice,” said Harripershad.
She alleged the officials then locked her in the room and said she had 15 minutes to sign the form, or they would call the police and have her arrested.
Harripershad said she was under duress when she signed the acknowledgement of debt, but as soon as she was able to speak to her attorney, she placed a stop order on the payments.
She said she had been fighting the scheme over its alleged unlawful action in court since then.
Harripershad said she had since lost two of her pharmacies as a result of Discovery Health’s “dark cloud”, a crime she believed she did not commit, hanging over her head.
The medical aid scheme stopped all claim payments to her pharmacies, she said.
“I’ve now approached the police after being advised by various people to do so.”
Discovery Health chief executive officer Jonathan Broomberg said the medical aid had substantial evidence that the pharmacy had supplied members with non-claimable items, such as baby formula, nappies, cosmetics and shoes, and then submitted claims for “prescription medicines”.
“There was also compelling evidence of instances where medicines were supplied to non-members and then claimed on a legitimate member’s membership.”
Broomberg denied that Discovery officials intimidated Harripershad and said there was no truth to the allegations.
“Discovery Health’s approach to investigating and dealing with fraud adheres to the very strictest standards, and meets the requirements of the Medical Schemes Act, and broader principles of legality,” Broomberg said.
“We have over the years invested considerable time, energy and resources to ensure that this is the case, and the principles applied have been tested and approved in prior litigation and this case was no different,” he said.
A formal complaint had been lodged against Harripershad with the South African Pharmacy Council, he said.
Police spokeswoman Brigadier Mathapelo Peters confirmed that Harripershad’s case had been registered at the Sandton police station.
It would be allocated to a detective for further investigation, Peters said.
Article by Sunday Independent