1, the insured deliberately fabricated the subject matter of insurance to defraud the insurance money. The "subject matter of insurance" mentioned here refers to the material wealth and other related interests, human life or body as the subject matter of insurance. "Deliberately fabricating the subject matter of insurance" means that when the applicant and the insurer conclude an insurance contract, they deliberately fabricate the nonexistent subject matter of insurance and conclude an insurance contract with the insurer. For example, lying that you own a car, signing an automobile insurance contract with an insurance company with the files of scrapped cars, and then lying that the car was stolen or robbed to defraud the automobile insurance money, is a typical fraud.
2. The applicant, the insured or the beneficiary fabricates false reasons or exaggerates the loss degree of the insured accident to defraud the insurance money. An insurance contract is generally conditional on a compensation agreement after the occurrence of an insured accident, and the insurer is not liable for the insured accident caused by any reason. If some property insurance contracts stipulate that the insurer shall not be liable for the accident losses caused by the fault of the applicant, the insured or the beneficiary. The term "fabricating the cause of an insurance accident" as mentioned here refers to making a false statement about the cause of an insurance accident or concealing the real situation. The so-called "exaggerating the degree of loss and defrauding insurance money" refers to deliberately exaggerating the losses caused by insurance accidents, thus defrauding more insurance money from insurance companies. There are various means and methods to deliberately exaggerate the loss, such as altering invoices and exaggerating losses.
3. The applicant, the insured or the beneficiary fabricates an insurance accident that has never happened to defraud the insurance money. The so-called "fabricating an insurance accident that never happened" refers to fabricating facts and falsely claiming that an insurance accident happened when the insurance accident never happened. In insurance activities, this situation is not uncommon, such as lying that the car was stolen or the property at home was stolen.
4. The applicant or the insured intentionally causes an insurance accident that causes property losses and defrauds the insurance money. This mainly refers to the behavior that the insured and the insured who insure property insurance deliberately create an insurance accident and defraud the insurance money during the validity period of the insurance contract. For example, in order to get compensation, set fire to the car, and then lied about accidental fire to defraud the insurance money.
5. The insured or beneficiary intentionally causes the death, disability or illness of the insured to defraud the insurance money. Personal insurance is an insurance that takes people's life and health as the insurance content. Except for a few types of insurance with the nature of "two-way" savings, this kind of insurance generally takes the death, injury or illness of the victim as the insurance subject. In this case, some policyholders and beneficiaries try their best to realize the compensation conditions in order to obtain insurance money. The term "intentionally causing death, disability or illness of the insured to defraud insurance money" here refers to the behavior of the insured or beneficiary to kill, injure, abuse, abandon, poison, spread infectious diseases and intentionally cause personal accidents by other means, resulting in death, disability or illness of the insured to obtain insurance money.
Second, how to identify the crime of insurance fraud
According to Article 198 of the Criminal Law, the crime of insurance fraud is only committed if the amount of insurance fraud is relatively large. It can be seen that the key to the difference between insurance fraud and non-crime lies in whether the amount of insurance money defrauded has reached a greater degree. For the act of defrauding a small amount of insurance money, if the circumstances are minor and the harm is not great, it can be handled as a general violation of the insurance law.
Insurance fraud is similar to general fraud: objectively, its criminal means are the same; Subjectively, there is the intention of fraud, with the purpose of illegal possession of public and private property. The main difference between them lies in the difference of subjects: the subject of insurance fraud is a special subject; The latter is a general subject, that is, anyone who reaches the age of criminal responsibility and has the ability of criminal responsibility can constitute it. In addition, they are also different in the object of crime: the former infringes on complex objects, that is, the property ownership of insurance companies and the national financial order; The latter infringes on the pure object, only the ownership of public and private property.