Ringleader of medical benefit fraud gang jailed


One employee orchestrated the fraud using fake invoices

He gave his colleagues fake invoices to help them get out of debt by practising the same fraud, for half of the ‘profit’

On Friday 30th August 2019 a man was jailed after he orchestrated a series of false medical claims made by him and five others, against their company’s medical benefits package.

Following an investigation by the City of London Police’s Insurance Fraud Enforcement Department (IFED), Kasim Mughal and four others in the group pleaded guilty to their respective involvement in making the fraudulent medical claims. The fifth person, Amanda Jowsey, was found guilty following a trial.

They were sentenced at Leeds Crown Court to the following:

  • Kasim Mughal, 35, of Leeds – 30 months in prison.
  • Daniel O’Leary, 38, of Leeds – 17 weeks in prison, suspended for 12 months. 150 hours unpaid work.
  • Paula Casey, 57, of Leeds – 17 weeks in prison, suspended for 12 months. 150 hours unpaid work.
  • Ladislay Prostecky, 36, of Wakefield – 100 hours unpaid work.
  • Karolina Maj, 28, of Wakefield – 100 hours unpaid work.
  • Amanda Jowsey, 41, of Leeds – 60 hours unpaid work.

Detective Constable Daryl Fryatt, from the City of London Police’s Insurance Fraud Enforcement Department, said:

“This group of fraudsters shamefully exploited their employer’s medical benefits package, in order to try and steal thousands of pounds.

“Mughal, who was the ringleader of this fraudulent activity, wasn’t content with making fake claims using only his and his family’s details. He also took advantage of the medical benefits by introducing his co-workers to the fraud, so that he could ultimately gain even more money by taking a cut of their claims."

Mughal took out health insurance policies for his family and himself with Simply Health Insurance, which provided medical treatment as part of his company’s health benefits’ package. Soon after taking out the policies, Mughal started making false claims for medical care. These included physiotherapy sessions for himself, plus dental and optical treatment for his daughter.

To substantiate these claims, Mughal provided Simply Health with fraudulent invoices from the health practices that he claimed he and his daughter had received the treatment from. In total, Mughal claimed for £1,061, though £785 was actually paid to him.

IFED discovered that as well as making his own fraudulent claims, Mughal had introduced a number of his co-workers to his criminal activity. Like Mughal, they also took out policies with Simply Health and made fake claims for medical treatment. In some instances, Mughal gave them the fake invoices he used to help back up their claims.

Although Paula Casey didn’t work at the company, her partner was an employee and she benefitted from the fraud by using his details to set up a policy and make false claims.

Amanda Jowsey didn’t work for the company either. However, she allowed her bank account to be used to receive claim payments from a policy that Mughal had set up, using the details of an unaware co-worker.

In return for introducing them to the fraud and assisting with their fake claims, half of the money each of them gained would be shared with Mughal.

The group made numerous claims, worth a potential £24,387 in total.