Dr. Birbal was tasked with investigating a claim made by Kamla, an elderly lady who had recently lost her husband. Kamla had been admitted to the G.C Gupta hospital with severe anaemia, AFI, and a fever. She had been experiencing weakness, high blood pressure, and raised heart rate for a week and had also been vomiting and suffering from loose motions for two days. She had also been experiencing breathlessness.
As Dr. Birbal delved deeper into the case, he found that Kamla had consulted Dr. Satpal, but no consultation papers were available. Kamla’s daughter, Poonam, provided the information to Dr. Birbal. Kamla’s haemoglobin level was low but the exact value was not known. Kamla was given two units of blood transfusion and was under the conservative management of Dr. Robin.
Dr. Birbal meticulously reviewed Kamla’s medical records including x-rays, an ECG, a urine test, and a blood test. He discovered that Kamla had a history of hypertension for seven years, which was treated by Dr. Satpal. Kamla also reported Insomnia since 3 years.
Knowing that it was a common cultural practice in Haryana to smoke hukka, Dr. Birbal questioned Kamla, even though she was a woman, determined to uncover any potential habits that may have contributed to her illness. As he dug deeper, Dr. Birbal found that Kamla had a habit of smoking Hukkah once daily for 3 years and had started smoking due to insomnia. Additionally, he discovered that Kamla had no bedside medication and no nebulizer or oral meds were given. The SPO2 level as per the documents was 80%, yet no oxygen support was given.
Dr. Birbal recommended that the insurance company reject Kamla’s claim. The reason was her habit of smoking and failure to disclose her hypertension when taking out the policy.
Xangarsinfra’s “Dr. Birbal stories” are true accounts of fraud detection by experienced medical professionals over video using Xangarsinfra’s video conferencing solutions. The names in these stories have been changed to protect the identities of those involved. These stories are meant to serve only as a learning resource and light Sunday reading.
