Life Insurance Fraud: Case Study

What is life insurance fraud? It is when someone deliberately misleads a life insurance company for financial gain. Common types of fraud range from lying on the policy application to faking an accident or even a death. Less common, but not relegated to movies, is the murder of an individual by an ultimate beneficiary who gains from the insurance payout.
Life Insurance Fraud Case Study
Life Insurance Fraud Case Study

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. 

FASCINATING FACTS: Life Insurance Fraud

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.

Chris Wilson former Hong Kong police

Our Corporate Private Investigator Origins

Veriton Investigations was co-founded in 2014 by an ex-Hong Kong police officer and a research/ communications professional.  They recognized a need in the private investigator industry to combine high quality reporting and analysis with discreet, feet-on-the-ground investigations and surveillance.  

Veriton Investigations is a brand of the Veriton Asia Group.  We offer a comprehensive portfolio of research and investigations services from full reputational due diligence and surveillance to China company checks, executive screening and process serves. 

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