Five charged with HK$130,000 insurance claim and commission fraud
2020-12-2
A former insurance agent and four policyholders were charged by the ICAC yesterday (December 1) in three cases for defrauding an insurance company of commissions and compensation on medical expenses totalling over HK$130,000 by making false representations in their policy applications and insurance claims.
Ng Wing-kei, 38, former insurance agent of AIA International Limited (AIA); and four policyholders, Yiu Chun-ho, 25, technician; Yiu King-huen, 25, ground crew; Yip Ka-po, 37, decoration worker; and Chan Ka-yu, 33, salesman, face a total of eight counts of conspiracy to defraud, contrary to Common Law.
The defendants will appear at the Eastern Magistrates’ Courts tomorrow (December 3) for plea.
The cases arose from a corruption complaint. Subsequent ICAC enquiries revealed the above alleged offences, which took place between June 2017 and April 2019.
AIA is an insurance company which provides different insurance products to its clients. When processing an application for taking out an insurance policy, AIA would consider the client’s occupation, annual income and medical history, etc.
When taking out a policy with an accident-riders add-on plan, a policyholder is entitled to reimburse medical expenses on an accountable basis with an extra compensation. Each claim has to be supported by relevant documents such as medical consultation receipts and sick leave certificates.
In the first case, Ng and Yiu Chun-ho face two counts of conspiracy to defraud. Ng further faces one count of conspiracy to defraud jointly charged with Yiu King-huen.
Two of the charges allege that Ng and Yiu Chun-ho conspired together and with another insurance agent of AIA (the second insurance agent) to defraud the company by falsely representing the occupation, monthly salary, average monthly expenditure and cumulative liquidated assets of Yiu Chun-ho, and that his right ankle was injured.
AIA was thus allegedly induced to approve Yiu Chun-ho’s insurance policy application and pay him insurance compensation, and pay commissions to Ng.
The remaining charge alleges that Ng and Yiu King-huen conspired together and with the second insurance agent to defraud AIA by falsely representing the occupation of Yiu King-huen, thereby inducing the company to approve his insurance policy application and pay commissions to Ng.
Ng was allegedly paid commissions totalling over HK$15,000 for the two policies while Yiu Chun-ho’s insurance claim was said to amount to about US$1,300 (about HK$10,000).
In the second case, Yip faces three counts of conspiracy to defraud which allege that Yip conspired together with the second insurance agent to defraud AIA by falsely representing Yip’s occupation and average monthly salary, and that his left shoulder and right wrist were sprained when lifting objects, and six sessions of physiotherapy treatments were attended.
It is alleged that AIA was induced to approve Yip’s insurance policy application which subsequently involved insurance compensation of over HK$20,000 and insurance claim of over US$3,800 (about HK$30,000). Commissions totalling over HK$8,800 was allegedly paid to the second insurance agent.
In the third case, Chan faces two counts of conspiracy to defraud. One of the charges alleges that Chan conspired together with the second insurance agent and a third insurance agent of AIA to defraud the company by falsely representing Chan’s occupation and that his right knee was injured, thereby inducing AIA to pay Chan insurance compensation of over HK$22,000.
The remaining charge alleges that Chan conspired together with the second insurance agent to defraud AIA by falsely representing that Chan’s right shoulder was injured and five sessions of physiotherapy treatments were attended, thereby inducing AIA to pay him insurance compensation.
The insurance claim was said to amount to over US$4,400 (about HK$34,000).
AIA has rendered full assistance to the ICAC during its investigation.
All defendants have been released on ICAC bail, pending their court appearance tomorrow.
Ng Wing-kei, 38, former insurance agent of AIA International Limited (AIA); and four policyholders, Yiu Chun-ho, 25, technician; Yiu King-huen, 25, ground crew; Yip Ka-po, 37, decoration worker; and Chan Ka-yu, 33, salesman, face a total of eight counts of conspiracy to defraud, contrary to Common Law.
The defendants will appear at the Eastern Magistrates’ Courts tomorrow (December 3) for plea.
The cases arose from a corruption complaint. Subsequent ICAC enquiries revealed the above alleged offences, which took place between June 2017 and April 2019.
AIA is an insurance company which provides different insurance products to its clients. When processing an application for taking out an insurance policy, AIA would consider the client’s occupation, annual income and medical history, etc.
When taking out a policy with an accident-riders add-on plan, a policyholder is entitled to reimburse medical expenses on an accountable basis with an extra compensation. Each claim has to be supported by relevant documents such as medical consultation receipts and sick leave certificates.
In the first case, Ng and Yiu Chun-ho face two counts of conspiracy to defraud. Ng further faces one count of conspiracy to defraud jointly charged with Yiu King-huen.
Two of the charges allege that Ng and Yiu Chun-ho conspired together and with another insurance agent of AIA (the second insurance agent) to defraud the company by falsely representing the occupation, monthly salary, average monthly expenditure and cumulative liquidated assets of Yiu Chun-ho, and that his right ankle was injured.
AIA was thus allegedly induced to approve Yiu Chun-ho’s insurance policy application and pay him insurance compensation, and pay commissions to Ng.
The remaining charge alleges that Ng and Yiu King-huen conspired together and with the second insurance agent to defraud AIA by falsely representing the occupation of Yiu King-huen, thereby inducing the company to approve his insurance policy application and pay commissions to Ng.
Ng was allegedly paid commissions totalling over HK$15,000 for the two policies while Yiu Chun-ho’s insurance claim was said to amount to about US$1,300 (about HK$10,000).
In the second case, Yip faces three counts of conspiracy to defraud which allege that Yip conspired together with the second insurance agent to defraud AIA by falsely representing Yip’s occupation and average monthly salary, and that his left shoulder and right wrist were sprained when lifting objects, and six sessions of physiotherapy treatments were attended.
It is alleged that AIA was induced to approve Yip’s insurance policy application which subsequently involved insurance compensation of over HK$20,000 and insurance claim of over US$3,800 (about HK$30,000). Commissions totalling over HK$8,800 was allegedly paid to the second insurance agent.
In the third case, Chan faces two counts of conspiracy to defraud. One of the charges alleges that Chan conspired together with the second insurance agent and a third insurance agent of AIA to defraud the company by falsely representing Chan’s occupation and that his right knee was injured, thereby inducing AIA to pay Chan insurance compensation of over HK$22,000.
The remaining charge alleges that Chan conspired together with the second insurance agent to defraud AIA by falsely representing that Chan’s right shoulder was injured and five sessions of physiotherapy treatments were attended, thereby inducing AIA to pay him insurance compensation.
The insurance claim was said to amount to over US$4,400 (about HK$34,000).
AIA has rendered full assistance to the ICAC during its investigation.
All defendants have been released on ICAC bail, pending their court appearance tomorrow.