SZV allowed to fire fraudulent employee

June 25, 2015 8:38 AM
PHILIPSBURG--The Court of First Instance ruled in favour of Social and Health Insurance SZV on Wednesday. SZV had sought the intervention of the Court in a procedure to dismiss one of its registration supervisors, who is suspected of having committed fraud with the distribution of health-insurance cards.
 
SZV requested that the Court terminate the labour agreement with its employee S.T.M. (27) as per March 17. The woman started her career with SZV in August 2005. She was promoted to the function of registration supervisor in June 2013.
 
The health insurer sought S.T.M.'s dismissal after it emerged there had been "irregularities" concerning the registration and issuance of health-insurance cards. Considering that M. was responsible for the correct execution of rules and regulations for registration and distribution of cards an investigation into her doings was started.
 
M. was suspended immediately pending the outcome of the investigation and ordered not to enter the SZV building and premises. The case also was reported to the police.
 
In the legal proceedings, M. did not contest the termination of her labour contract, but claimed to be entitled to NAf. 61,090.30 in compensation.
She allegedly committed fraud with SZV cards by handing these out to persons who were not entitled to them. These cards have been retracted in the meantime, SZV stated.
 
The ex-SZV worker denied she had sold the cards. The Court also did not find any proof that she had obtained financial gain or favours in return for her services. Therefore, it remained unclear why she had decided to assist certain companies, employees and their family members.
 
However, it could be established that M. had violated important procedures and had misused her position as a supervisor to order other SZV-employees to facilitate these companies and their workers.
 
For instance, M. had admitted the spouse of an insured person without proper verification. She also had arranged medical appointments for persons without the required authorisation of an SZV doctor and outside of the regular appointment system.
 
She also had issued insurance cards incorrectly to employees and family members of a "suspect" company G&D Industrial Janitors and Construction Services and on behalf of "fictitious" workers of Maccow Foundation, the Court stated.
 
The woman had defended herself in stating that she had not been the only one who had violated procedures. According to her, the head of her department also had done another employee of G&D a favour.
 
According to the judge, it could be derived from an "upsetting" WhatsApp message between the department head and M. that the department head also had not been against giving preferential treatment. However, the Court was of the opinion that this was no justification for M.'s "reproachable" behaviour.
 
The judge arrived at the conclusion that there were sufficient grounds for SZV to terminate the contract and ordered M. to pay the legal costs of the procedures, which were estimated at NAf. 1,500.
 
The Daily Herald

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