Five policyholders charged by ICAC over $280,000 insurance claim fraud


Five policyholders were charged by the ICAC yesterday (June 28) in separate cases for allegedly conspiring with others to deceive an insurer into granting a number of applications for accident insurance claims made by them and releasing them compensation and reimbursement of medical expenses totalling over $280,000 by making false representations about their injuries.

The defendants are five policyholders of AIA International Limited (AIA), aged between 31 and 35. Renee Li Yin, clerk; Rachataphruksa Anusorn, restaurant worker; Yeung Lung, head of compliance; Lam In-kwan, accountant, and Tam Kai-chun, clinical team leader; face a total of 12 counts of conspiracy to defraud, contrary to Common Law.

The defendants were released on ICAC bail, pending their appearance in the Eastern Magistrates’ Courts tomorrow (June 30) for plea.

The cases took place between November 2016 and July 2018. At the material time, the defendants had each taken out an AIA life insurance policy with an accident rider through a referrer engaged by an insurance broker.

The five insurance policies covered disability compensation, accident medical expenses reimbursement and accident indemnity. An accident insurance claim had to be supported by documentary proof, including receipts of medical consultations or treatments and sick leave certificates issued by doctors or physiotherapists.

The charges allege that the defendants individually conspired together with the referrer to defraud AIA by dishonestly falsely representing that 12 applications for accident insurance claims purportedly supported by documentary proof were genuine, thereby causing and inducing AIA to approve the applications and release compensation and reimbursement of medical expenses ranging from over $20,000 to over $100,000 to each defendant. The total compensation and reimbursement amounted to $280,000.

The defendants had allegedly made false representations in the above accident insurance claims that they had received medical treatment for their injuries and were unable to work for a total of around 160 days due to temporary disabilities.

The ICAC investigation arose from a corruption complaint. The five policyholders were charged after seeking legal advice from the Department of Justice. As the relevant corruption investigation is continuing, the ICAC does not rule out further law enforcement actions.

AIA has rendered full assistance to the ICAC during its investigation into the case.

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