Disability insurance fraud group busted in Taiwan

Disability insurance fraud group busted in Taiwan | Insurance Business Asia

Life & Health

Disability insurance fraud group busted in Taiwan

A couple collaborated with an agent to defraud millions in Taiwanese dollars

Life & Health

By
Kenneth Araullo

The Criminal Bureau of Investigation (CBI) in Southern Taiwan has busted a disability insurance fraud group case implicating a couple who also collaborated with an insurance agent.

The married pair, surnamed Kang and Li, aided 11 policyholders in faking serious medical conditions like strokes to file false insurance claims. Over a two-year period, this group amassed NT$7.59 million (US$236,000) from insurance premiums. The couple took a 20% share from each claim according to a Taiwan News report.

All 13 individuals involved were interrogated. When police visited the homes of those possessing disability certificates, their condition appeared normal, allowing them to move freely without assistance.

Following the interrogations, Kang and Li, along with the other individuals, confessed to the insurance fraud. All 13 individuals were then handed over to the Tainan district prosecutor’s office for further investigation and face charges of fraud.

Fraud investigation timeline

During the investigation, it was disclosed that the couple also had prior convictions for fraud. They were acquainted with an insurance agent named Xu, who would reach out to the policyholders and promote disability insurance.

The couple would then wait for six months to a year before instructing the policyholders to mimic symptoms of a suspected stroke, such as one-sided limb weakness and numbness, after which they would seek medical attention.

To ensure the deception remained undetected during medical examinations, Kang reportedly instructed the policyholders to feign symptoms of physical paralysis, speech impairment, and dementia. They were coached to inform doctors that a stroke would impair their ability to earn a living.

After receiving medical diagnoses of strokes, the policyholders claimed disability insurance payouts. Starting in 2020 until their exposure in August, at least 11 individuals feigned illness and applied for compensation.

During home inspections by assessors, Li demonstrated how to pretend to be paralysed in a chair and even aided claimants in changing their diapers. Subsequently, the realization that all the policyholders were assisted by the same agent, lived in Tainan, and travelled to Kaohsiung for medical consultations raised suspicions of an organized insurance fraud scheme. This led to the CBI filing a case.

Police evidence indicated that, despite having medical reports suggesting paralysis due to strokes, the policyholders were physically active, engaging in activities like running and kung fu. Their social media accounts also showcased pictures of them driving go-karts.

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