Policyholder charged with $550,000 medical insurance claims fraud
2014-4-29
A policyholder has been charged by the ICAC with deceiving medical insurance compensation totalling about $550,000 from eight authorised insurers by falsely representing that he had been hospitalised at a hospital in the Mainland during various periods du e to accidents.
Simon Lee Kwok-fung, 58, a building attendant, who was charged yesterday (Monday), faces a total of 21 counts of fraud, contrary to Section 16A of the Theft Ordinance.
The defendant, currently on ICAC bail, will appear in the Eastern Magistracy at 9:30 am tomorrow (Wednesday) for transfer to the District Court for plea.
The case arose from a corruption complaint. Subsequent ICAC enquiries revealed the above alleged offences.
At the material time, the defendant had taken out 12 medical insurance polices from eight authorised insurers. Pursuant to the insurance 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 charges allege that between March 25, 2011 and December 28, 2012, the defendant falsely represented to the eight authorised insurers that he had been hospitalised at Shenzhen Luogang Hospital for four separate consecutive periods of 18/19 days, amount ing to 73 days in total, and that medical expenses were incurred.
It is alleged that with intent to defraud, the defendant induced the eight authorised insurers or their agents to pay compensation totalling about $550,000 to him.
The eight authorised insurers had rendered full assistance to the ICAC during its investigation.
Simon Lee Kwok-fung, 58, a building attendant, who was charged yesterday (Monday), faces a total of 21 counts of fraud, contrary to Section 16A of the Theft Ordinance.
The defendant, currently on ICAC bail, will appear in the Eastern Magistracy at 9:30 am tomorrow (Wednesday) for transfer to the District Court for plea.
The case arose from a corruption complaint. Subsequent ICAC enquiries revealed the above alleged offences.
At the material time, the defendant had taken out 12 medical insurance polices from eight authorised insurers. Pursuant to the insurance 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 charges allege that between March 25, 2011 and December 28, 2012, the defendant falsely represented to the eight authorised insurers that he had been hospitalised at Shenzhen Luogang Hospital for four separate consecutive periods of 18/19 days, amount ing to 73 days in total, and that medical expenses were incurred.
It is alleged that with intent to defraud, the defendant induced the eight authorised insurers or their agents to pay compensation totalling about $550,000 to him.
The eight authorised insurers had rendered full assistance to the ICAC during its investigation.