An article in The Telegraph says that the multi-billion dollar problem of fraud across the medical world has been officially acknowledged. Even Dubai has admitted that patients in the emirate may be “over-diagnosed” and detained in hospital longer than necessary. The director of the Dubai Health Authority, is launching a scheme to regulate services provided by private hospitals across the UAE. He said: “Sometimes people are kept longer than necessary in a hospital or an intensive-care unit. These kinds of things are daily issues that insurance members face and they need to be protected.” Foreign nationals in Dubai, for whom insurance is mandatory, should welcome the development.

But medical fraud is far from uniquely a Middle Eastern practice. It is estimated to add 10 per cent to medical premiums across the globe. Countries with large expatriate communities head the list of offenders. People anxious about their health in a foreign country are easy targets. Insurers struggle against relatively borderline offenses, such as prescribing unwanted pain-killers, to over-diagnosis such as ordering unneeded MRI scans, to full-scale criminal activity by organized gangs.

InterGlobal, the insurer for expatriates, which won the 2012 industry award for unmasking criminal activity, can guarantee picking up a fraudulent claim every day, such is the extent of the problem. InterGlobal is now part of Aetna.The company played a key part in revealing a massive fraud in which a criminal ring is said to have submitted scores of bogus claims to numerous insurers over a 10-year period. The operation was fronted by a virtual hospital, non-existent consultants and a 24-hour switchboard. As Paul Weigall, InterGlobal’s sales and marketing director, put it, the hospital was “just a telephone in the desert”. He added: “A lot of insurers were caught out. We got on to the case and were only very lightly affected.”

The Middle East was a major zone of concern, he said. China is often quoted as another hot spot. “You’ll find a group of people who have built up a fabricated health care system, which will include hospitals, doctors and customers – making it very difficult for an insurer not to pay out on a claim that’s submitted. Then we find that nothing of that actually exists.

“We’ve been invoiced by a hospital that gives an address, answers a phone when we ring and then we find that hospital doesn’t exist. There are a number of people who are looking, on a very large basis, to defraud people. “However, there are also hospitals that overcharge. For example, you need 20 aspirin, they charge you for 200.”