Life Insurance Fraud Investigation in China (Case Study)
A major Australian Insurance company asked us to investigate a potential life insurance fraud that occurred, in part, in China. The company wanted the life insurance investigations to be discreet, empathetic and thorough. Furthermore, we needed to obtain as much supporting evidence as possible. As a result, our investigator visited numerous hospitals and local courts.
- WHO: Australian Insurance Company
- WHAT: Suspicion of life insurance fraud
- WHY: Short period between effective date and death
- WHERE: Investigations and interviews in rural area of China
LIFE INSURANCE FRAUD INVESTIGATION
CASE STUDY: China
Private Investigator Obtained:
- Witness Statements
- Doctor’s Report
- Death Certificate
This was a complex case involving several locations. The TAT was 2 weeks.
Background
This particular life insurance case study involved understanding the exact circumstances of the death of a woman in her 30s. She was born in China but had become a permanent Australian resident.
Immediately after learning that she had terminal cancer, the woman visited her parents in a rural area of China. Here, she sought medical treatment. In the meantime, she also managed to purchase multiple life insurance policies.
Shortly afterwards, she flew back to Melbourne to begin treatment. A few months later, she returned again to China where she passed away. Just before her death, the woman declared her illness to the insurance company and instigated claims against the policies.
Client Concerns
Our client was suspicious about the timing of the claims. It was at this point they asked us to investigate the potential life insurance fraud.
We assigned one of our Hong Kong-based private investigators, who is fluent in Putonghua (Mandarin) to the case. In total, he managed to identify four hospitals in which the woman had had either treatment or consultations. Furthermore, he spoke to various witnesses— including one of the doctors— and obtained a copy of the death certificate. He also checked with local courts for debt-related trials. Consequently, we discovered that one of the deceased woman’s immediate relatives had financial difficulties.
Our researchers made informal translations into English for several of the more relevant excerpts of documents retrieved by our investigator.
We prepared a detailed report for the client with witness statements, photographs and copies of supporting documentation.
According to the blogsite Fortunly.com, the Reinsurance Group of America estimates that life insurance fraud costs the US insurance industry between $10 and $20 billion annually.