The national health insurance fund (CNAM) reported that insurance fraud [4] has reached 287 million EUR (321.4 million USD) in 2019.
The fraud identified mainly comes from health professionals and institutions. In 2019, 1650 agents checked 13 million invoices, they conducted 23 000 investigations and opened 8 800 litigation files.
The investigations show that 48% of the fraudsters are healthcare providers such as pharmacists, doctors and ambulance drivers. Healthcare institutions come second with 31% of the frauds. The insured are liable for only 21% of the total loss of the CNAM.
Investigators have uncovered fraud networks on the Internet which provide online false work stoppages and invoices for medical expenses. The CNAM has also reported that the fraudulent acts are not caused by the use of the “carte vitale”.