Law

Traces Found in Medical Records: Prosecutors Dig Deep and Find out a Fiction Traffic Accident Insurance Fraud Case

2023-03-21   

Both parties to the accident were freight station employees, and the accident occurred within the freight station. Various "coincidences" made the prosecutor feel that the case was unusual. Recently, the truth of a fictitious traffic accident insurance fraud case surfaced after thorough investigation by the Cixi City Procuratorate in Zhejiang Province. In June 2022, when the Cixi City Procuratorate tried to arrange through the civil litigation supervision clue screening system in the special action of "Looking Back on False Litigation", a seemingly ordinary traffic accident case came into the sight of the prosecutor. In this case, the unloading employee was injured by a freight driver. After mediation by the court, the vehicle insurance company compensated for the medical expenses of the injured person. "Both parties involved in the accident were employees of a freight station in Cixi, and the location of the accident occurred within the freight station. Is this a coincidence or an ulterior motive?" With years of experience in handling cases, the prosecutor believed that the case might involve false litigation, and decided to initiate an investigation. However, after many years, the original traces of the accident scene have long been lost, and the driver has also sought another way out. The victim has no memory due to brain damage, and all clues seem to have entered a "dead end". In order to find the truth, the prosecutor retrieved the file materials of the traffic accident of that year and decided to find a breakthrough. Finally, the prosecutor found clues in an initial medical record: "The patient Liu fell from a height of one meter, injuring his head, and immediately became delirious." The traffic accident identification document clearly recorded that the freight driver was negligent when backing up in the unloading area, and collided with the victim standing there, causing the other party to fall to the ground and be injured. Did the victim fall or get hit? The descriptions of the cause of the victim's injury in the two materials differ greatly. In addition, the prosecutor found clues such as "non first scene reporting" in an insurance claim material at the time of the incident. Based on the above materials, the prosecutor has preliminarily judged that this may be a planned "insurance scam". The Cixi City Procuratorate informed the insurance company concerned of the above situation. The truth of a fictitious traffic accident insurance scam gradually surfaced. One day in December 2017, Liu Mou, an employee of a cargo consignment station in Cixi City, accidentally fell from a height while loading and unloading goods, causing his head to land. The owner of the freight station, Zhang, heard the news in his office and immediately ran outside the house to inspect it. He saw that Liu was bleeding continuously and had fallen into a coma. He was alarmed and felt that the situation was serious. As Liu did not have work-related injury insurance, Zhang was worried about having to bear a huge amount of medical expenses. Therefore, Zhang took up the idea of vehicle insurance. He first instructed the freight driver Ma to call the traffic police to report the case, falsely claiming that he accidentally knocked down the unloading and transporting worker Liu during the loading and starting of the vehicle, forging the illusion that Liu was injured in a traffic accident. Upon investigation, the traffic police department issued a traffic accident identification opinion, confirming that Ma was fully responsible for the accident, and Zhang obtained the "pass" for the vehicle insurance claim as he wished. After submitting relevant materials to the insurance company to settle the claim without success, Zhang used Liu, who lost his memory after the injury, to file a civil lawsuit with the court. After mediation, both parties reached an agreement that the insurance company would compensate Liu for the relevant expenses and pay the treatment expenses advanced by Zhang in advance. In this way, Zhang and Ma defrauded a total of over 430000 yuan in compensation. In July 2022, the public security organ arrested Zhang; August of the same year

Edit:Ying Ying Responsible editor:Jia Jia

Source:jcrb.com

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