The traffic police brigade of the Public Security Bureau was restored on the spot
The whole process from the occurrence of the accident to the insurance claim
However, once you master the relevant processes
The members of the case team still have doubts:
Two cars collide
The vehicle is bound to be damaged and actual losses will occur
What do criminals make money on?
"Post-90s" Wang has many companies under his name, many Mercedes-Benz cars, and he is generous and generous on weekdays, and he is a proper "big boss" in the eyes of outsiders. As everyone knows, behind Wang's "success" is closely related to an unknown business - with the rapid growth of motor vehicle ownership in the mainland, the share of motor vehicle insurance in the insurance market has gradually increased, and some criminals have identified "business opportunities", started a fraudulent insurance "business", and tried to obtain court judgment support by filing false lawsuits, Wang is one of these people.
According to statistics, from April 2022 to June 2023, the Pingdu Municipal Procuratorate of Shandong Province lodged a protest with the Qingdao Municipal Procuratorate on six false lawsuits in the field of motor vehicles, and issued retrial procuratorial recommendations to the Pingdu Municipal Court for nine cases, recovering losses of more than 1.44 million yuan for insurance companies. At present, 6 related cases are still pending.
Ask the "experts" and clear the fog of deception
"We were recently working on an insurance fraud case that may involve sham litigation, so let's study it together." One day in February 2022, the "invitation" issued by the criminal prosecution department of the Pingdu Municipal Procuratorate to the civil prosecution department of the procuratorate caused a high degree of vigilance by civil prosecutor Xu Xuhui. He did not hesitate, raised his foot and went to "go to the invitation".
After flipping through the thick criminal case files, checking the preliminary examination report of the criminal prosecution department, and communicating with the criminal prosecutor, Xu Xu will find that the members of the criminal gang have a special relationship, and many accidents have occurred between relatives or acquaintances.
According to the usual operation, when encountering such situations, Xu Xuhui will inquire about relevant cases on the China Judgment Documents Network. During the inquiry, Wang entered Xu Xuhui's line of sight.
On the China Judgment Documents website, Xu Xuhui found a number of civil lawsuits filed by Wang in the name of himself, his relatives, and the auto repair shop he controlled, in the name of motor vehicle traffic accident liability disputes. Based on years of experience in handling civil prosecution cases, Xu Xuhui believes that the insurance fraud case is likely to involve multiple civil false lawsuits.
After fully studying and judging the clues in its possession, the civil prosecution department of the Pingdu Municipal Procuratorate immediately set up a case-handling team composed of a prosecutor, an assistant procurator and a clerk to handle the case. However, the members of the team are not experts in the field of motor vehicle accidents, and it is not easy to understand the door behind the "professional" process of insurance fraud.
In order to clear the fog of insurance fraud as soon as possible, the case handling team contacted the staff of the insurance company and came to the traffic police brigade of the Pingdu Public Security Bureau together to restore the whole process from the accident to the insurance claim on the spot. However, after mastering the relevant process, the members of the case team still have doubts: if two vehicles collide, the vehicle will definitely be damaged and actual losses will occur, what do criminals rely on to make money?
The procurator in charge has an in-depth understanding of the insurance company's insurance process and the application of big data
"Combing through the entire claims process, I can't see any tricks, and the problem should be in the car maintenance link." The case-handling team made a preliminary judgment. In order to solve the mystery, the case team visited several auto repair shops in the jurisdiction, but the staff there either excused themselves as busy with work or refused to answer on the grounds that it was inconvenient to say more about industry secrets. When there was no way out, someone remembered that a relative of his friend ran an auto repair shop. After explaining the situation to a friend and obtaining the consent of his relatives, the case team came to the auto repair shop to find out the situation.
The procurator visited the motor vehicle repair shop to inquire about the basis for assessing the damage of the vehicle
The visit was very rewarding. The owner of the auto repair shop detailed to the case team some "secrets" of the illegal auto repair shop first transferring parts and then creating accidents. "Back and forth, the profit is very considerable, especially some more expensive brand cars, the repair cost of large accessories is often tens of thousands of yuan, hundreds of thousands of yuan." The owner of the garage said.
As the investigation deepened, the insurance fraud process gradually became clearer, and the case handling team carried out further review on whether Wang deliberately caused a traffic accident and filed a false lawsuit to defraud the insurance claim payment. On the basis of accessing the court's original trial files, the case-handling team took the initiative to connect with the procuratorial personnel responsible for undertaking relevant criminal cases, guiding them to interrogate Wang in a targeted manner, questioning the top driver involved in the case, and further consolidating the evidence. Finally, with the assistance of criminal prosecutors, the case handling team found that Wang had committed illegal acts of causing traffic accidents and fraudulently obtaining insurance claims by filing false civil lawsuits in a number of insurance fraud cases.
The procurator in charge questioned the persons involved in the insurance fraud
Based on the facts ascertained, the Pingdu Municipal Procuratorate promptly reported to the Qingdao Municipal Procuratorate. The Qingdao Municipal Procuratorate gave full play to the advantages of "integrated procuratorial handling" in handling cases, strengthened command and guidance, and formed a strong case-handling joint force between the two levels of procuratorates from summarizing evidence to forming a review report to filing a protest or issuing a retrial procuratorial recommendation, effectively improving the quality and efficiency of supervision. At the same time, the Pingdu Municipal Procuratorate also transferred other false litigation cases discovered in the handling of the case that had been rendered by the Qingdao Intermediate Court to ensure that supervision did not leave a dead end.
Data "speaks"
A series of false lawsuits are difficult to hide
On July 19 this year, Wang was sentenced to 14 years in prison for insurance fraud and fraud. Under the supervision of the procuratorates at the Qingdao and Pingdu levels, a series of false lawsuits concocted by them were also corrected, recovering losses of more than 1.2 million yuan for insurance companies.
"Is Wang's case a case or a similar case? Are other insurance companies similarly fraudulent? After handling Wang's case, Xu Xu would raise this question with the case handling team. After discussion, everyone decided to dig deep into the clues of false litigation supervision in the field of motor vehicle insurance.
However, it is difficult to achieve by manpower alone to complete the sorting out of a large number of effective judgments in this field in a short period of time and dig out the supervision clues that can be completed by manpower alone, so the case handling team handed over the heavy responsibility of assisting in the screening of clues to the big data supervision model. By entering the information of Wang and his relatives, as well as the auto repair shop related to him in the past ten years, into the big data model, after comparison, collision and analysis, the case handling team found batch supervision clues.
"Supervision and handling of cases is not the goal, but promoting governance is the ultimate goal." Based on this concept, on August 17, the Pingdu Municipal Procuratorate publicly announced to relevant insurance companies "face-to-face" the delivery of procuratorial suggestions in response to the problems existing in insurance companies found in the process of handling false litigation supervision cases involving motor vehicle insurance, and suggested that insurance companies strengthen and improve their work in on-site inspection, response to litigation, claims settlement, etc., so as to reduce and eliminate the occurrence of insurance fraud.
After the relevant insurance company adopted the inspection recommendation, it quickly launched rectification. First of all, the insurance fraud risk prevention and control system has been improved. Internally, the insurance fraud cases and false litigation supervision cases handled by the procuratorate are used as anti-fraud education materials, and full-coverage publicity is given to employees, and professional quality training is carried out to improve the ability of insurance salesmen to identify insurance fraud; Remind the policyholder of the nature and legal consequences of insurance fraud throughout the process, and prevent insurance salesmen and auto maintenance personnel from colluding and jointly committing insurance fraud. Second, improve the basic information filling system of motor vehicle insurance. Relying on the existing internal system, in the motor vehicle insurance part, optimize the system data filling content, and list the license plate number, damage part, accident location, driver, repair manufacturer and other information of the insured vehicle as mandatory items for claim settlement, so as to facilitate the retrieval and screening of important data. Finally, establish a reporting mechanism for insurance fraud leads and a referral filing system. On the one hand, regularly sort out and inquire about the insurance claims in the basic information filling system of motor vehicle insurance, pay close attention to and investigate the license plate numbers and drivers who have repeatedly taken out insurance in a short period of time, and promptly transfer relevant clues and evidence to the public security organ and record them with the procuratorate for the suspected insurance fraud problems found. On the other hand, legal personnel of insurance companies are required to enhance their professional sensitivity and vigilance when representing motor vehicle insurance liability compensation cases, pay attention to suspicious situations found in litigation, and communicate with judicial authorities in a timely manner.
As of press time, a large insurance company has passed the implementation of the procuratorial recommendations and handed over one clue to the public security organ on a case suspected of insurance fraud. At present, the case is under preliminary investigation.
Strive for "foreign aid" and form a joint force for governance
False litigation itself has strong concealment, and false litigation in the field of motor vehicle insurance is not only highly concealed, but also highly professional. In long-term illegal and criminal activities, under the leadership of individual illegal auto repair shop owners, some people are responsible for overall planning, some people are responsible for specific operations, some people are greedy for free car repairs and other small bargains knowingly commit crimes, and some people are pulled to help... Relatives and friends came together to gradually form a special insurance fraud industry chain.
In order to accurately solve the problem of frequent false litigation in this field and help optimize and improve the business environment based on the rule of law, the Pingdu Municipal Procuratorate deeply analyzed the causes of the problems found in the process of handling the case, studied countermeasures and suggestions, and submitted an analysis report to the Municipal Party Committee and the Political and Legal Committee of the Municipal Party Committee, which was affirmed by the main leaders of the Municipal Party Committee and its Political and Legal Committee.
At the same time, under the unified coordination and leadership of the Pingdu Municipal Party Committee and its Political and Legal Committee, relying on the cross-departmental big data case-handling platform of political and legal organs, in addition to actively sharing clue information, all departments of the city's public prosecution and legal departments have also established a false litigation information exchange data platform and a compulsory retrieval system for litigation-related cases in the field of motor vehicle insurance, forming a relatively hard and relatively fixed mechanism guarantee. At the same time, promote the open source sharing of false litigation leads in the field of motor vehicle insurance, open up information exchange channels between law enforcement and judicial organs and insurance industry associations, and achieve source governance.
"Motor insurance fraud not only threatens the financial security of our insurance companies, but also leads to an overall increase in premiums in the motor insurance industry, thereby harming the public interest. In addition, insurance fraud in the motor vehicle sector has always been a 'pain point' in the governance of the insurance industry, and when we find suspicious claims to report to the public security organs during the process of inspecting and settling claims, we are often denied by the public security organs because the amount of fraud does not meet the standards for filing criminal cases. In the process of responding to civil litigation, in view of the principle of 'who claims, who produces evidence' in civil litigation, we often have to stop the false litigation fraud that is discovered and highly suspected because of the strong concealment of insurance fraud and the fact that insurance companies do not have the right to investigate and verify. The person in charge of a large insurance company said with emotion, "Through supervision and investigation and verification in accordance with the law, the procuratorate found out the 'giant rat' of insurance fraud, which not only recovered the loss of funds for us, but also helped us find a feasible solution to the problem, which greatly promoted the sustainable, stable and healthy development of the insurance industry. ”
Aftermath:
In recent years, insurance fraud in the field of motor vehicle insurance has been common, and the prosecutor has summarized the following reasons for the frequent and frequent occurrence of such illegal acts: First, some auto repair shop employees are well versed in the processes and standards of accident identification, insurance claims, and auto repair, and their long-term work experience and convenient conditions have triggered their unscrupulous intention of opportunism and making quick money, so they try the law by example and pull their relatives, friends, classmates, fellow villagers, etc. to do insurance fraud "business"; Second, some policyholders lack a correct understanding of auto insurance, and even regard insurance as an investment, believing that after insurance, if they do not take out insurance or receive compensation during the insurance period, they will send money to the insurance company in vain, so in order to recover or reduce their premium "loss", they also join the ranks of insurance fraud; Third, some participants in false lawsuits or insurance fraud cases are just "helping" out of face, while others are greedy for free car repairs or taking advantage of small bargains to receive small gifts, etc., and provide vehicles and related documents to others, and are pulled onto the "thief ship" in a confused way.
Here, the prosecutor reminds the majority of motor vehicle drivers to drive carefully when going out, and to report to the police in time in the event of a traffic accident, and handle claims according to law; When carrying out car maintenance, you should also try to choose a regular store, keep your eyes open, and be vigilant, and must not be used by criminals because of greed for small and cheap.
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Source: Procuratorial Daily Minsheng Weekly