A senior surgeon accused of fraud and forgery says the investigation into his conduct left him feeling “hounded, bullied and anxious”, a court has heard.

Mohammed Suhaib Sait is on trial for allegedly inflating claims to private insurers for procedures he completed while at Fawkham Manor Hospital in Longfield between 2011 and 2015.

The 61-year-old is accused of completing multiple keyhole knee surgeries but charging for a more complicated and expensive procedure when it came to his private patients.

The Nightingale Court, at the Mercure Great Danes Hotel near Maidstone, heard claims Sait had received an extra £12,100 from insurers AXA and Aviva after changing codes to a more costly procedure.

Prosecutor Serena Gates previously explained how a simpler and cheaper operation to remove the meniscus was given the code W8200, while a more involved one to repair the joint was given W8230.

There was between a £100 to £150 difference in price for the procedures, depending on which insurer patients were with.

Ms Gates said Sait earned thousands of pounds extra every year over three years from both insurers – something the surgeon says was only around 2.5 per cent of his yearly salary – by inflating the claims.

When asked why he changed the codes, he said: “I thought my procedure – preserving the meniscus – fell into the W8230. My understanding was W8230 was the closest code to my procedure.”

The court heard how an investigation was launched in June 2015 into his billing. It was concluded before the New Year after Sait allegedly provided copies of letters from AXA and Aviva clearing him of any wrongdoing. The prosecution claims these letters were forged.

In February 2016, Sait received an email from his responsible officer at Darent Valley Hospital – someone who looks over a doctor’s work and fitness to practice – asking to see the letters.

“I didn’t send her the letters as I didn’t know why she wanted them,” he explained.

He claims in June 2016 he received a “threatening” letter from the same person telling him he would be reported to the General Medical Council (GMC) if he didn’t comply.

Sait added: “This was the first time in my life something like this had happened.

“I felt hounded, bullied. I had fear, was anxious and stressed.”

Previously, the prosecution told the court how AXA and Aviva denied sending any letters to Sait confirming he had been billing his procedures correctly and they had agreed for him to change the codes.

Ms Gates alleges Sait showed two letters to BMI Healthcare executive director Valerie Power and regional director Peter Harris claiming he was given the all-clear. Sait denies this.

He claims he met with Ms Power and presented her with two drafted letters he wanted her to approve to send to each insurer which they could approve.

However, Ms Power and Mr Harris claim a photocopy of this letter was shown during a meeting which Sait allegedly portrayed as genuine, and as a result, they ended the investigation.

When questioned by Ms Gates why he had signed one of the draft letters as insurance worker Michael Joyce, Sait replied he was experiencing “fear, anxiety and stress” and it wasn’t his “normal behaviour”.

Speaking about using an AXA and Aviva letterhead on his draft letters, he said: “I can’t give a clear explanation. There was anxiety, stress, fear. I wasn’t thinking straight. I wasn’t doing it to mislead.”

The court also heard how following an audit from Bupa before the June 2015 BMI investigation, the insurer had noticed Sait’s procedure codes were being changed.

After challenging him on this, Sait agreed to pay the difference – a sum of around £12,100 –back to the healthcare provider.

Sait also faces a charge of sending a malicious anonymous letter falsely accusing his colleague Dr Michael Thilagarajah.

The bogus letter claimed to be from a nurse and made an allegation the experienced orthopaedic surgeon had performed a surgery unnecessarily and badly, as well as sexually assaulting the patient.

This was “completely false and without any base,” Ms Gates told the court.

Analysis of the letter, after it was passed to the police, showed some components of Sait’s DNA on the adhesive envelope strip.

On Friday, the court heard statements from the defence about Sait’s good character.

The father-of-four was described as a “caring and compassionate” surgeon and someone who would always help the community.

One former trainee described him as one of the best consultants he had worked under and as “respectful and professional”.

The trial continues on Monday, December 18.