Two years’ jail for deceiving $436,000 medical insurance claims
2014-7-7
A policyholder, charged by the ICAC, was today (Monday) sentenced to two years’ imprisonment at the District Court for having deceived medical insurance compensation totalling over $436,000 from eight authorised insurers by falsely representing that he had been hospitalised at a hospital in the Mainland during various periods due to four accidents.
Simon Lee Kwok-fung, 58, a building attendant, earlier pleaded guilty to 15 counts of fraud, contrary to Section 16A of the Theft Ordinance, while the prosecution offered no evidence to six similar offences against him.
In sentencing, Judge Mr Sham Siu-man reprimanded the defendant for using fraudulent means to deceive over $436,000 from eight authorised insurers on 15 occasions in more than 20 months.
The judge added that the starting point of three years in jail was reduced to two years after taking into account his guilty plea and various mitigating factors.
The case arose from a corruption complaint. Subsequent ICAC enquiries revealed the above offences.
The court heard that at the material time, the defendant had taken out a number of medical insurance polices from eight authorised insurers in Hong Kong.
Apart from two insurance policies taken out through an agent of one of the eight authorised insurers, the other insurance policies were taken out through telemarketing.
Pursuant to those policies, the defendant was entitled to claim hospital cash benefit and medical expenses if he had been hospitalised as a result of accidental injuries or sickness.
The court heard that between March 25, 2011 and December 24, 2012, the defendant filed claims with the eight authorised insurers for hospital cash benefit and medical expenses purportedly incurred from four accidents that took place in the Mainland.
With invoices, receipts and medical reports allegedly issued by the Shenzhen Luogang Hospital in the Mainland, the defendant claimed that he had been injured in the four accidents and hospitalised for a total of 73 days between March 6, 2011 and December 21, 2012.
In the belief that the claim forms and related supporting documents were genuine, the eight insurers released payments totalling over $436,000 to the defendant.
However, immigration records revealed that the defendant stayed in Hong Kong for a total of 58 days during the purported hospitalisation periods, the court was told.
The eight authorised insurers had rendered full assistance to the ICAC during its investigation.
The prosecution was today represented by Public Prosecutor Joycelyn Ng, assisted by ICAC officers Ellen Tong and Freddy Yip.
Simon Lee Kwok-fung, 58, a building attendant, earlier pleaded guilty to 15 counts of fraud, contrary to Section 16A of the Theft Ordinance, while the prosecution offered no evidence to six similar offences against him.
In sentencing, Judge Mr Sham Siu-man reprimanded the defendant for using fraudulent means to deceive over $436,000 from eight authorised insurers on 15 occasions in more than 20 months.
The judge added that the starting point of three years in jail was reduced to two years after taking into account his guilty plea and various mitigating factors.
The case arose from a corruption complaint. Subsequent ICAC enquiries revealed the above offences.
The court heard that at the material time, the defendant had taken out a number of medical insurance polices from eight authorised insurers in Hong Kong.
Apart from two insurance policies taken out through an agent of one of the eight authorised insurers, the other insurance policies were taken out through telemarketing.
Pursuant to those policies, the defendant was entitled to claim hospital cash benefit and medical expenses if he had been hospitalised as a result of accidental injuries or sickness.
The court heard that between March 25, 2011 and December 24, 2012, the defendant filed claims with the eight authorised insurers for hospital cash benefit and medical expenses purportedly incurred from four accidents that took place in the Mainland.
With invoices, receipts and medical reports allegedly issued by the Shenzhen Luogang Hospital in the Mainland, the defendant claimed that he had been injured in the four accidents and hospitalised for a total of 73 days between March 6, 2011 and December 21, 2012.
In the belief that the claim forms and related supporting documents were genuine, the eight insurers released payments totalling over $436,000 to the defendant.
However, immigration records revealed that the defendant stayed in Hong Kong for a total of 58 days during the purported hospitalisation periods, the court was told.
The eight authorised insurers had rendered full assistance to the ICAC during its investigation.
The prosecution was today represented by Public Prosecutor Joycelyn Ng, assisted by ICAC officers Ellen Tong and Freddy Yip.