Since the beginning of the pandemic, many services have moved online, including issuing insurance policies. Now you can insure your car, apartment, health or life without even leaving your home. But at the same time, Internet scammers became more active. They attract clients with cheap policies, which in fact turn out to be fake and do not protect against risks in any way. We'll tell you what schemes criminals use and what to do when scammers call and offer to take out insurance.
CASCO and OSAGO are leaders in the number of frauds in the insurance industry
According to statistics, more than 10% of the total number of CASCO and OSAGO policies in Russia are fake. Often, motorists do not even suspect that they are driving with fake insurance. Falsification is only discovered during an accident.
EXAMPLE:
| 24-year-old Moscow resident Olga R. bought her first car. After signing the purchase and sale agreement, the girl immediately went to the traffic police to register the car. Near the branch, Olga was stopped by a pleasant-looking man and said that he would help him take out a combined MTPL + CASCO policy for only 15 thousand rubles. The offer seemed extremely profitable to Olga: the vehicle is almost new, so CASCO must be purchased in any case. She agreed to the deal and bought insurance. The policy was on company letterhead, with a stamp - everything was as it should be. But a month later, the girl got into an accident and the inspector who arrived at the scene of the accident upset Olga: the insurance was fake. As a result, the owner of the car had to repair both her own and someone else’s car at her own expense. In total, Olga spent 280 thousand rubles on the restoration of two vehicles. |
A certain category of citizens deliberately purchases fake policies, wanting to save money. Car owners are confident that nothing will happen to them on the road. But, besides accidents, there are several other situations where fake insurance is fraught with trouble:
- Checking documents by a traffic police officer. If the inspector discovers that CASCO or OSAGO are not real, the car owner faces a fine of 800 rubles.
- Traveling abroad by car. Border guards examine the documents in detail. A fake policy will most likely cause you to be denied entry into another country.
- Attempting to obtain payment from a fake insurance policy. In this case, the client will not only not benefit, but will also become a defendant in a criminal case.
Don't risk your money and health! Cooperate only with reliable insurance companies. Accidentally bought a fake document? Contact the police. The sooner you do this, the higher the chances that the insurance fraudster will not have time to escape and will suffer a fair punishment.
Fraud by insurance company employees
More than half of all cases of insurance fraud in the Russian Federation are carried out with the help of employees of insurance organizations. Even criminal communities can form, the basis of which is an unscrupulous insurance employee who decides to take advantage of his position in order to obtain illegal profits.
Security departments of insurance companies record the following facts of fraud:
Execution of an insurance contract retroactively (after the occurrence of an insurance situation).
Deliberate exaggeration of actual damage to increase the amount of insurance payments. In this case, the insurance employee is entitled to a percentage of the compensation received.
Conspiracy between an insurance company employee, service station workers and the client. In this case, the cost of repair work and spare parts that require replacement is inflated. The difference between the actual costs and the insurance compensation paid is divided between the three interested parties.
Misrepresentation of the facts of the occurrence of an insured situation in order to obtain compensation.
Distribution of fake insurance policies or blank contract forms.
Fake mortgage insurance
Are you planning to get a mortgage? Please note: the bank will ask you to insure the property, as well as the life and health of the borrower. This is a mandatory condition for issuing a preferential targeted loan. By law, you can take out insurance from any company. The main thing is not to enter into an agreement with scammers. The bank has the right to terminate a transaction with an unscrupulous client, but it will be extremely difficult to prove its non-involvement.
Buy a policy from a trusted, reliable institution. Have you chosen a new insurance company that is not yet known to anyone? Check on the website of the Central Bank of the Russian Federation whether it has a license to operate. All insurers must be included in the register of the Central Bank.
Types of fraud
There are different types of fraud, the most common among them are:
- Falsification of documents. Occurs at the stage of issuing a policy and attempting to obtain compensation as a result of an insured event.
- Intentional causing of harm. To obtain compensation, some swindlers arrange circumstances that contribute to the occurrence of an insured event.
- Intentional exaggeration of losses and causing harm to health. It is used by clients for the same purpose - to get as much compensation as possible from the insurer.
- Concealment of data affecting the terms of the contract. Here, the culprits can be both clients and financial institutions. On the part of policyholders, there were cases of concealment of data about the actual condition of the object or subject of insurance, and on behalf of the insurance company - deliberate distortion of information in the contract, for example, about the impossibility of receiving a refund of part of the premium in case of early termination of insurance. Excluding a clause from the terms of the contract is also insurance fraud.
REFERENCE! Fraud in the insurance industry can be carried out by one person or by a group by prior conspiracy. In the second case, the punishment for the criminal act may be maximum. According to Art. 159 of the Criminal Code of the Russian Federation, a group of fraudsters may face up to 10 years in prison.
How to recognize a scammer
Insurance company agents have the right to enter into contracts on behalf of the organization, but they must have a power of attorney. It is this document that confirms the legality of the transaction. The power of attorney bears the seal of the institution and the signature of the director. Still in doubt? Contact the insurance company by phone, it will take a couple of minutes. Look up the number on the Internet. Check with the person who answered the phone to see if there is an employee with that first and last name. You are required to give information.
What points should you be wary of:
- refusal of the insurer to show a passport, agency agreement or power of attorney;
- filling out papers by hand;
- issuing a policy without a diagnostic card and without using the information database of the RSA - Russian Union of Auto Insurers;
- payment only in cash, refusal to issue a check and receipt;
- low cost of the policy.
The agent is in a hurry to answer and says: is the special price offer valid only today? This is also a suspicious point: scammers get the client emotional. Don't rush to sign documents and give money. It's better to double check everything. Insurance should really protect against risks, and not just be a piece of paper “for show”.
How to protect yourself from charges of “insurance fraud” (Article 159.5 of the Criminal Code of the Russian Federation)
Lawyer Antonov A.P.
Another special type of fraud is insurance fraud. By analogy with the compounds discussed above, it is special solely because of the area in which thefts are committed, namely insurance relations. Chapter 48 of the Civil Code of the Russian Federation contains the concepts of an insured event, insurance compensation, insured, etc. According to Art. 927 of the Civil Code of the Russian Federation, insurance is carried out on the basis of property or personal insurance contracts concluded by a citizen or legal entity (policyholder) with an insurance organization (insurer). According to Art. 938 of the Civil Code of the Russian Federation, as insurers, insurance contracts can be concluded by legal entities that have permits (licenses) to carry out insurance of the corresponding type. The requirements that insurance organizations must meet, the procedure for licensing their activities and the supervision of these activities are determined by insurance laws. Insurance activities are regulated by the Law of the Russian Federation of November 27, 1992 N 4015-1 “On the organization of insurance business in the Russian Federation.” According to paragraph 2 of Art. 9 of this Law, an insured event is defined as an event that has occurred, provided for by an insurance contract or by law, upon the occurrence of which the insurer becomes obligated to make an insurance payment to the policyholder, the insured person, the beneficiary or other third parties. When it comes to insurance fraud, we mean situations of committing fraudulent actions by deceiving the occurrence of an insured event (for example, providing false information about the existence of circumstances confirming the occurrence of an insured event, namely staging an accident, car theft, etc. .) or the amount of insurance compensation to be paid (for example, if the insured event actually occurred, but knowingly false information about the amount of damage is provided). In essence, the so-called corporate insurance is no different from insurance for individuals, except that the insured is a legal entity. For example, LLC “R” has a car and a garage on its balance sheet, the risk of loss or damage of which is insured on the basis of an appropriate insurance contract. There is a fire in the garage, which you manage to put out on your own, but the car is not there at the time of the fire. The general director of R LLC, with the intent to steal funds from the insurance company, fakes the theft of a car, and also provides authorized employees with knowingly false information regarding fire-damaged property, which increases the amount of insurance compensation, when drawing up the report. As a result, the insurance company is provided with false information regarding the occurrence of an insured event (car theft) and the amount of insurance compensation (inaccurate information about damaged property). If in this case the general director of LLC “R” also contacts the police with a statement about the theft of a car, then his actions will be classified as a set of crimes, i.e. according to Art. Art. 159.5 and 306 of the Criminal Code of the Russian Federation (knowingly false denunciation of a crime). Advice: in order to avoid situations related to false suspicions of fraud in the insurance industry, when concluding insurance contracts, you should report the actual value of the property, without trying to inflate the value of the damaged property or exaggerate the damage in the event of an insured event. Otherwise, your actions may be regarded as intent to steal funds from the insurance company. As qualifying features of the crime under consideration, the legislator establishes the commission of these actions: - by a group of persons by prior conspiracy, as well as causing significant damage to a citizen; - by a person using his official position, as well as on a large scale; - by an organized group or on a particularly large scale.
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How to report fraud
The answer to this question is quite simple: if you become a witness or participant in insurance fraud, you must immediately contact the police. There you will need to draw up a statement about fraud, which should contain your personal data and a description of the situation that occurred, indicating all the persons who, in your opinion, are involved in this violation.
At the end of the application, the phrase “In view of the above, I request that a criminal case be initiated against the specified person(s) under Article 159.5 of the Criminal Code of the Russian Federation” must be written and a signature must be placed. Based on such a statement, the police will conduct a preliminary check, which will result in the initiation or non-initiation of a criminal case.
Responsibility
Fraud in property insurance is punishable by law. The Criminal Code of the Russian Federation provides for liability under several articles. Depending on the harm and danger to society, those responsible for crimes and scams can be sentenced to various terms.
Different categories of participants have their own individual and collective responsibilities. Fines are provided for all types of crimes. There are also those in which payments can be 100 times more than the material damage caused.
Fraud involving third parties
Frequently, insurance fraud is carried out by seemingly uninterested persons. Accomplices will be required for the following insurance scams:
Staging an accident or other insured incident. For such fraud you will need the assistance of police officers, doctors or firefighters. They will prepare false protocols, medical certificates, extracts from non-existent medical records, and expert assessments to obtain insurance compensation.
Concealment of circumstances related to the insured event. This type of fraud scheme may involve experts, police officers, doctors, ambulance workers, and false witnesses.
It should be noted that in real life, various insurance fraud schemes are interconnected. Having unraveled the insurance scam, you can find out that clients of the insurance company, its employees, representatives of law enforcement agencies, experts, and doctors took part in it for the purpose of profit. Such organized crime in the insurance industry makes it very difficult to detect fraud and is the reason for the increase in losses in the insurance business.
Corpus delicti
This may include illegal actions aimed at obtaining financial gain. For example:
- provision of knowingly false information when concluding an insurance contract - concealment of incurable diseases when insuring life;
- concealment of information about events that led to the occurrence of an insured event - the accident was caused by a driver who was driving without a license;
- staging an insured event - an intentional accident, imitation of injury;
- deliberate actions for the purpose of obtaining payments - damage to insured property, murder of a person who insured the life.
In all of these cases, the actions are premeditated, which implies a crime.
