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Thursday, Dec 09, 2021

four held in cancer insurance scam

The anti-graft body believes it has smashed a syndicate that cheated an insurance company out of HK$26 million in critical illness insurance.
In an operation last month, four core members of the syndicate aged between 39 and 59 years were arrested - a former insurance agent, a policyholder, an intermediary and a cancer patient, according to the Independent Commission Against Corruption. More arrests may come.

The case, which happened between 2017 and last year, involved four insurance policies, two of which were purchased by Hongkongers while the other two were purchased by mainlanders. The highest compensation in one of the policies was HK$9 million.

Four hospitals - two local and two in the mainland - and three local medical institutions were also involved in the case.

The ICAC said the insurance agent first purchased a high-compensation critical illness insurance policy with an annual premium of about HK$280,000 before asking a cancer patient, who is of similar age and appearance to the policyholder, to conduct a body check at a medical center or hospital.

The lymphoma proof obtained was then used to cheat the insurance company, for which the policyholder could receive HK$9 million in compensation.

The ICAC discovered that the insurance agent received a HK$2 million bribe, while the policyholder, intermediary and the cancer patient were offered rewards ranging from tens of thousands to several million dollars.

The insurance agent also received a HK$2.5 million bribe.

In another operation, the ICAC arrested 22 people - a former regional director of an insurance company, three branch managers and 18 former insurance agents - for defrauding two insurance companies of about HK$51 million in commissions.

The four seniors had hired the 18 people aged between 25 to 30 with no work experience and told them that they didn't have to sell any insurance products, ICAC said.

Further investigation showed that the four former senior employees falsely told the two insurance companies that the 18 agents sold as many as 480 insurance products and got HK$5.1 million in commission fees between 2018 and last year.

For the first nine months of this year, ICAC received 32 corruption complaints related to the insurance industry, compared to only 14 cases in the first nine month last year.

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