What is insurance fraud? What is the situation called insurance fraud?

Provisions of the National Insurance Act:

The first circumstance limits the insurance company's insurance fraud, as stipulated in the Insurance Law) If the insurance company and its staff deliberately fabricate an insurance accident that has not occurred to make a false claim and defraud the insurance money, which constitutes a crime, they shall be investigated for criminal liability in accordance with the law.

The second circumstance is limited to the insured's fraudulent act of insurance fraud) deliberately creating an insured accident and obtaining compensation from the insurance company on this basis. It's also a insurance fraud. After the accident, the insured or his permitted driver drives the insured motor vehicle or abandons the insured motor vehicle to flee the accident scene without taking measures in accordance with the law, or deliberately destroys or falsifies the scene or destroys evidence, all of which are insurance fraud.

Insurance fraud means defrauding medical insurance funds, which is a problem of collusion between hospitals and patients inside and outside to defraud medical insurance costs. For example: illegal overcharging, substitution of project set charges, decomposition of hospitalization; altering medical documents, swiping social security cards to prescribe drugs on behalf of others, and taking up posts without qualifications; Falsification of medical records, private distribution of fraudulent medical insurance**; The insured falsified bills, repeatedly prescribed drugs with multiple social security cards, etc.

Insurance fraud is a problem of collusion between the hospital and the patient inside and outside to defraud the medical insurance fee, the patient is acting, the diagnosis is fake, and the ward is empty.

What is insurance fraud? Insurance fraud is caused by participating in insurance or artificially caused when you know that you are sick.

Fraudulent insurance by pretending to be sick.

Legal analysis: Insurance fraud means defrauding medical insurance funds, which is a problem of collusion between hospitals and patients inside and outside to defraud medical insurance costs. The following situations are medical insurance fraud:

Allowing or inducing a non-insured individual to be hospitalized in the name of the insured. The medical expenses paid by the insured individuals and at their own expense shall be paid by the medical insurance**. Hospitalization with a bed or hospitalization of an insured individual who is eligible for outpatient treatment**.

Excessive medical treatment or unnecessary medical services are provided by means such as duplication**, duplication or no indication**, decomposition hospitalization for insured individuals. Violating the provisions of the medical insurance on the scope of medication or the variety of medication, using excessive medication, repeated medication, illegal use of drugs with special restrictions, or dispensing drugs for insured individuals by decomposing or changing prescriptions. The expenses incurred by non-designated medical institutions are combined with the expenses of designated medical institutions and settled with medical insurance agencies.

Assist the insured individual to obtain the personal account of medical insurance**or co-ordinate**. Unauthorized raising of fee standards, increase of fee items, decomposition of fees, repeated charges, expansion of the scope of fees and other illegal charging behaviors. Fraud, fraudulent use of false reports, false data, etc. to obtain medical insurance** or personal accounts**.

Legal basis: Article 198 of the Criminal Law of the People's Republic of China? In any of the following circumstances, where insurance fraud is carried out, and the amount is relatively large, a sentence of up to five years imprisonment or short-term detention is to be given, and a concurrent fine of between 10,000 and 100,000 RMB is to be given; where the amount is huge or there are other serious circumstances, a sentence of between 5 and 10 years imprisonment and a concurrent fine of between 20,000 and 200,000 RMB is to be given; where the amount is especially huge or there are other especially serious circumstances, a sentence of 10 or more years imprisonment is to be given, and a concurrent fine of between 20,000 and 200,000 RMB or confiscation of property is to be given

1) The policyholder deliberately fabricates the subject matter of insurance and defrauds the insurance money; (2) The policyholder, the insured or the beneficiary fabricates false reasons for the occurrence of the insured accident or exaggerates the extent of the loss, thereby defrauding the insurance money; (3) The policyholder, the insured or the beneficiary fabricates an insurance accident that has not occurred to defraud the insurance money; (4) The insured or the insured intentionally causes an insurance accident of property damage and defrauds the insurance money; (5) The policyholder or beneficiary intentionally causes the death, disability or illness of the insured and defrauds the insurance money. Where the conduct listed in items (4) and (5) of the preceding paragraph concurrently constitutes other crimes, punishment is to be given in accordance with the provisions on combined punishment for multiple crimes. Where a unit commits the crime in the first paragraph, the unit is to be fined, and the directly responsible managers and other directly responsible personnel are to be sentenced to up to five years imprisonment or short-term detention; where the amount is huge or there are other serious circumstances, a sentence of between 5 and 10 years imprisonment is to be given; where the amount is especially huge or there are other especially serious circumstances, a sentence of 10 or more years imprisonment is to be given.

Where an appraiser, certifier, or property appraiser of an insured accident intentionally provides false supporting documents to provide conditions for others to defraud, it is to be punished as an accomplice to insurance fraud.

To commit murder is to pretend to die unexpectedly.

Legal Analysis: The definition of insurance fraud refers to the act of deliberately creating the false impression that the guarantor has died or been injured, so as to defraud the insurance company of insurance money. There are two types of insurance fraud:

1. The insurance company and its staff deliberately falsified insurance accidents that did not occur to make false claims. 2. The insured intentionally causes an insurance accident and receives compensation from the insurance company. It's also a insurance fraud.

Legal basis: Article 174 of the Insurance Law of the People's Republic of China Where the policyholder, the insured or the beneficiary commits any of the following acts, and the insurance fraud activities do not constitute a crime, an administrative penalty shall be imposed in accordance with law:

1) The policyholder deliberately fabricates the subject matter of insurance and defrauds the insurance money;

2) Fabricating insurance accidents that have not occurred, or fabricating false causes of accidents or exaggerating the extent of losses, to defraud insurance money;

3) Intentionally causing an insured accident and fraudulently obtaining insurance money.

Where an appraiser, evaluator, or certifier of an insured accident intentionally provides false supporting documents to provide conditions for the policyholder, insured, or beneficiary to commit insurance fraud, punishment shall be given in accordance with the provisions of the preceding paragraph.

Insurance fraud is a kind of insurance fraud, and it is common to cheat on medical insurance and insurance

Insurance fraud can be committed by both parties to the insurance. If the policyholder of the insurance relationship does not abide by the principle of good faith, deliberately conceals the true information of the relevant insurance object, induces the insurer to underwrite, or uses the content of the insurance contract to deliberately create or fabricate the insurance accident to cause damage to the insurance company in order to obtain insurance compensation, it is a fraud of the policyholder.

Insurers are guilty of fraud if they lack the necessary solvency or operate their business without approval, and take advantage of the opportunity to draw up insurance terms and insurance rates, or exaggerate the scope of insurance liability to induce or deceive policyholders and insureds. Once insurance fraud is carried out, it will inevitably cause harmful results, and it is necessary to strictly guard against it.

Insurance fraud is a kind of insurance fraud, and it is common to cheat on medical insurance and insuranceIf the policyholder of the insurance relationship does not abide by the principle of good faith, deliberately conceals the true situation of the relevant insurance object, induces the insurer to underwrite, or uses the content of the insurance contract to deliberately create or fabricate the insurance accident to cause damage to the insurance company in order to obtain insurance compensation, it is a fraud of the policyholder.

Insurance fraud refers to buying insurance in advance and then deliberately creating an accident to make compensation.

Tianbao is to defraud the insurance amount through abnormal channels, for example, alas! People have diseases, and then they get insurance, and then this or that. Fake someone who had an accident, and then cheat that kind of big insurance. If it's this, it's a deception.

Insurance fraud means to buy insurance after the fact or premeditated, in order to earn the insurance amount for the purpose of carrying out the behavior, this behavior is illegal, and it is easy to identify, do not cheat insurance.

If you cheat the insurance, you will cheat the insurance company's money, and if you cheat the insurance company's money, you will cheat the insurance company's money!