Mount Everest Climbers 'Poisoned' By Guides In Insurance Fraud Scheme (kathmandupost.com) 1
schwit1 shares a report from the Kathmandu Post: In Nepal, helicopter rescue on high altitude is, by any measure, a genuine lifesaving operation. At high altitude, where oxygen thins and weather changes without warning, the ability to airlift a stricken trekker to Kathmandu within hours has saved countless lives. But threaded through that legitimate system, exploiting its urgency, its opacity, and its distance from oversight, is one of the most sophisticated insurance fraud networks in the world. Nepal's fake rescue scam is not new. The Kathmandu Post first exposed it in 2018. Months later, the government convened a fact-finding committee, produced a 700-page report, and announced reforms. In February 2019, The Kathmandu Post published a long investigative report. Last year, Nepal Police's Central Investigation Bureau reopened the file, and what they found is that the fraud did not stop -- instead it was growing.
The mechanics of the fake rescue racket are straightforward: stage a medical emergency, call in a helicopter, check a tourist into a hospital, and file an insurance claim that bears little resemblance to what actually happened. But the sophistication lies in how each link in the chain is compensated, and how difficult it is for a foreign insurer -- operating from Australia and the United Kingdom -- to verify events that occurred at 3,000 metres in a remote Himalayan valley. The CIB investigation identifies two primary methods for manufacturing an "emergency." The first involves tourists who simply don't want to walk back. After completing a demanding trek -- an Everest Base Camp trek, for instance, can take up to two weeks on foot -- guides offer an alternative: pretend to be sick, and a helicopter will come. The guide handles the rest. The second method is more troubling. At altitudes above 3,000 meters, mild symptoms of altitude sickness are common. Blood oxygen saturation can drop, hands and feet tingle, headaches develop. In most cases, rest, hydration or a gradual descent is all that is needed. But guides and hotel staff, according to the CIB investigation, have been trained to terrify trekkers at precisely this moment. They tell them they are at risk of dying, that only immediate evacuation will save them. In some cases, investigators found that Diamox (Acetazolamide) tablets, used to prevent altitude sickness, were administered alongside excessive water intake to induce the very symptoms that would justify a rescue call.
In at least one case cited in the investigation, baking powder was mixed into food to make tourists physically unwell. Once a "rescue" is called, the financial choreography begins. A single helicopter carries multiple passengers. But separate, full-price invoices are submitted to each passenger's insurance company, as if each had their own dedicated flight. A $4,000 charter becomes a $12,000 claim. Fake flight manifests and load sheets are fabricated. At the hospital, medical officers prepare discharge summaries using the digital signatures of senior doctors who were never involved in the case. In some cases, these are done without those doctors' knowledge. Fake admission records are created for tourists who were, in some documented instances, drinking beer in the hospital cafeteria at the time they were supposedly receiving treatment. In one case, an office assistant at Shreedhi Hospital admitted that he had provided his own X-ray report taken about a year ago at a different hospital, to be used as a case for treatment of foreign trekkers to claim insurance. The commission structure that holds the network together was described in detail during police interrogations. Hospitals pay 20 to 25 percent of the insurance payment to trekking companies and a further 20 to 25 percent to helicopter rescue operators in exchange for patient referrals. Trekking guides and their companies benefit from inflated invoices. In some cases, tourists themselves are offered cash incentives to participate.
The mechanics of the fake rescue racket are straightforward: stage a medical emergency, call in a helicopter, check a tourist into a hospital, and file an insurance claim that bears little resemblance to what actually happened. But the sophistication lies in how each link in the chain is compensated, and how difficult it is for a foreign insurer -- operating from Australia and the United Kingdom -- to verify events that occurred at 3,000 metres in a remote Himalayan valley. The CIB investigation identifies two primary methods for manufacturing an "emergency." The first involves tourists who simply don't want to walk back. After completing a demanding trek -- an Everest Base Camp trek, for instance, can take up to two weeks on foot -- guides offer an alternative: pretend to be sick, and a helicopter will come. The guide handles the rest. The second method is more troubling. At altitudes above 3,000 meters, mild symptoms of altitude sickness are common. Blood oxygen saturation can drop, hands and feet tingle, headaches develop. In most cases, rest, hydration or a gradual descent is all that is needed. But guides and hotel staff, according to the CIB investigation, have been trained to terrify trekkers at precisely this moment. They tell them they are at risk of dying, that only immediate evacuation will save them. In some cases, investigators found that Diamox (Acetazolamide) tablets, used to prevent altitude sickness, were administered alongside excessive water intake to induce the very symptoms that would justify a rescue call.
In at least one case cited in the investigation, baking powder was mixed into food to make tourists physically unwell. Once a "rescue" is called, the financial choreography begins. A single helicopter carries multiple passengers. But separate, full-price invoices are submitted to each passenger's insurance company, as if each had their own dedicated flight. A $4,000 charter becomes a $12,000 claim. Fake flight manifests and load sheets are fabricated. At the hospital, medical officers prepare discharge summaries using the digital signatures of senior doctors who were never involved in the case. In some cases, these are done without those doctors' knowledge. Fake admission records are created for tourists who were, in some documented instances, drinking beer in the hospital cafeteria at the time they were supposedly receiving treatment. In one case, an office assistant at Shreedhi Hospital admitted that he had provided his own X-ray report taken about a year ago at a different hospital, to be used as a case for treatment of foreign trekkers to claim insurance. The commission structure that holds the network together was described in detail during police interrogations. Hospitals pay 20 to 25 percent of the insurance payment to trekking companies and a further 20 to 25 percent to helicopter rescue operators in exchange for patient referrals. Trekking guides and their companies benefit from inflated invoices. In some cases, tourists themselves are offered cash incentives to participate.