Care fraud investigation — facts when you suspect healthcare abuse
False billing, PGB fraud or phantom care? We investigate discreetly and deliver legally admissible evidence you can act on immediately.
- ✓ Experience with PGB fraud, billing fraud and phantom care
- ✓ Legally admissible evidence for administrative and criminal proceedings
- ✓ Discreet investigation without disrupting the care relationship
- ✓ Combined use of surveillance, digital investigation and administrative analysis
Corporate
Care Fraud Investigation
Healthcare fraud costs the Dutch society hundreds of millions of euros annually. It involves deliberate deception — care that was never provided yet billed, personal care budgets (PGB) spent on unrelated expenses, inflated hour records, or clients pressured into complicity. For health insurers, municipalities, care offices and healthcare organisations, suspicions are often difficult to substantiate. That is where investigation comes in. SAJ Recherche conducts targeted investigations into fraud patterns in the healthcare sector and delivers a factual, verifiable case file.
What we investigate
What forms of care fraud do we investigate?
We investigate the most common forms of healthcare fraud. Billing fraud — care that was not or only partially delivered yet fully billed. PGB fraud — personal care budgets spent on non-care-related expenses. Phantom care — fictitious clients or treatments that exist only on paper. Upcoding — reporting more expensive treatments than actually performed. Unlicensed care provision — staff without proper qualifications delivering care.
Who do we work for?
Health insurers verifying fraud signals. Municipalities auditing PGB expenditure. Care offices investigating irregular long-term care claims. Healthcare organisations suspecting internal abuse. Industry bodies safeguarding sector quality and integrity.
What does the investigation deliver?
You receive a complete investigation file with factual findings, supported by surveillance reports, digital analyses and administrative evidence. The report is prepared for use in administrative proceedings (reclaims, fines), criminal complaints or internal measures. We report objectively and factually — no assumptions, only evidence.
Want to discuss your situation?
Contact us for a free, confidential consultation.
How we work
Intake and signal analysis
You share your suspicions and available signals. We assess whether there is sufficient grounds for investigation and design a proportionate investigation plan.
Investigation execution
Depending on the case, we deploy surveillance, administrative auditing, digital investigation or a combination. The investigation is conducted entirely discreetly.
Analysis and reporting
All findings are analysed and compiled into a clear report. You receive concrete conclusions with supporting evidence.
Advice and next steps
We advise on possible follow-up actions: filing complaints, reclaims, contract termination or escalation to regulators. If needed, we support the legal proceedings.
Intake and signal analysis
You share your suspicions and available signals. We assess whether there is sufficient grounds for investigation and design a proportionate investigation plan.
Investigation execution
Depending on the case, we deploy surveillance, administrative auditing, digital investigation or a combination. The investigation is conducted entirely discreetly.
Analysis and reporting
All findings are analysed and compiled into a clear report. You receive concrete conclusions with supporting evidence.
Advice and next steps
We advise on possible follow-up actions: filing complaints, reclaims, contract termination or escalation to regulators. If needed, we support the legal proceedings.
⚖️ Legal framework
SAJ Recherche operates in compliance with the Dutch Private Security and Investigation Agencies Act (Wpbr) and the General Data Protection Regulation (GDPR/AVG). All investigations are conducted under POB licence 8779, issued by the Ministry of Justice and Security.
Legal recognition and licences
Frequently asked questions
What exactly is care fraud?
How do you detect care fraud?
Is the investigation legally admissible?
How quickly can a care fraud investigation start?
What does a care fraud investigation cost?
Can you also advise on prevention?
Read more about care fraud investigation
Ready for the next step?
Schedule a free intake meeting and discover how we can help.