Source | Procuratorial Daily
A large number of insured persons surrendered their insurance irregularly under the inducement of the "insurance black property gang", which not only caused damage to the huge property of the insurance company and the legitimate rights and interests of the insured, but also seriously affected the business environment of the insurance industry.
Since the end of last year, the Shanghai Jing'an District Procuratorate has successively accepted 15 cases of 61 people in such "insurance black industry gangs", with a cumulative amount of about 6 million yuan.
The persons involved in the case include former insurance practitioners, social idlers, insurance agents of insurance companies and back-office personnel.
On September 28, the Shanghai Jing'an District Court held a hearing on Xu Mouyi's job embezzlement case, in which Xu Mouyi confessed to his act of instructing zhang moumou, the business director, and others to use the hanging order method to cause the insurance company to give more rewards to insurance agent newcomers totaling 1.84 million yuan, and profiting more than 300,000 yuan from it, and voluntarily admitted guilt and punishment. In the end, the court sentenced him to two years and six months in prison and a fine of 90,000 yuan for the crime of usurpation of office.
Three months earlier, on June 15, the court sentenced Xiao and others to fixed-term imprisonment ranging from eight months to six months for the crime of infringing on citizens' personal information, and fined them ranging from 25,000 yuan to 6,000 yuan respectively. On the 28th, the Jing'an District Procuratorate filed a public prosecution against Xu Moujia and Zhu Moumou on suspicion of embezzlement of office and infringement of citizens' personal information, and the court has not yet made a judgment.
Pry orders
Let customers refuse to pay the old policy and buy a new policy
Since August 2020, the public security organs have accepted a number of fraudulent reports. The staff of the insurance company who reported the case said that during their inspection, they found that some social personnel impersonated the company's insurance agents to carry out business in other provinces and cities, illegally "pry orders", and finally hung the new insurance policy in the names of some insurance agents of the company's Shanghai branch, thereby defrauding the insurance company of commissions and causing huge economic losses to the insurance company.
After accepting the case, the public security organs quickly ascertained the organizational structure, personnel distribution and circumstances of the "insurance black industry gang" involved in the case, and from October to November 2020, they arrested Xu Moujia and Zhu Mou, the leading members of the "insurance black industry gang" involved in the case, and other black industry personnel and the insurance company "internal ghost" Zhang Mou. During the investigation, the public security organs found that the insurance policies involved in the case were all genuine insurance policies. In this case, can it be considered a fraud crime? In order to accurately grasp the characterization of the case, the public security organs took the initiative to invite the Jing'an District Procuratorate to intervene in advance.
Liu Bosong, procurator of the Third Procuratorial Department of the Jing'an District Procuratorate, and others formed a case-handling team under the leadership of Deputy Procurator General Lu Hao. At the beginning of November 2020, the case-handling team, together with the public security organs, listened to the introduction of the insurance company staff many times, and found that the case was the leading elements of the "insurance black industry gang" Xu Moujia, Zhu Mou and others who left the insurance company's affiliated company, gathered idle members of the society to form an "insurance black industry gang", posing as the insurance agent of the insurance company to sell insurance policies, in order to avoid being reported by the insured or discovered by the insurance company inspection, Xu Moujia and others exhibited in Guangdong, Hubei, Zhejiang and other provinces to return from sales and donate epidemic prevention materials. Under the pretext of explaining the old insurance policy, etc., he took the initiative to visit the customer, and used the internal policy upgrade activities to make the customer refuse to pay the old policy and purchase the new policy, and successfully "pry the order". Subsequently, the "insurance black industry gang" colluded with the insurance agent of the insurance company to hang the new insurance policy in the name of other insurance agents of the insurance company, and collected the commission and reward of the insurance company through other insurance agents and divided it up.
These people are not insurance company employees, how do they get information about the insured? Since it is a real insurance policy, why should it be "pending order"?
The prosecutor and the police re-combed the case and found that these people used their own names when visiting customers, but used other people's names when signing insurance policies. After the insurance company checked the insurance agents whose names were used, they found that they were all insurance agent newcomers who had been employed by the insurance company for less than one year, and under the arrangement of "people with hearts", they lent the account to the middle-level management personnel such as Zhang X, who had management responsibilities for them, and Zhang X and others colluded with Xu X and others, so they could use these insurance agent new person accounts to generate new insurance policies and withdraw commissions.
It turns out that within insurance companies, in order to motivate new people, insurance agents are usually given more commission rewards. According to reports, the same insurance policy sales performance is hung under the name of these insurance agent newcomers, up to 1.5 to 1.6 times the insurance agent's commission for the elderly, and the personnel involved in the case will divide this part of the commission and earn excess benefits. For the insured, once the old policy is surrendered, it will not be covered during the insurance waiting period.
collusion
Inside and outside should cheat insurance companies of newcomer allowances
The prosecutor handling the case discusses the merits of the case
In December 2020, the public security organs submitted the case to the Jing'an District Procuratorate for arrest on the grounds that Xu X. A, Zhu X X, Zhang X X, and others were suspected of embezzlement of office. The case-handling team believes that although there is a general judgment in the early intervention stage, accurate characterization is the premise of handling this case, and it will also point out the direction for follow-up investigation.
The case-handling team re-sorted out the facts of the case. On the whole, Xu X. A, Zhu X X and others colluded with the middle-level management personnel such as Zhang X of the insurance company, and the former required the latter to use its responsibility to manage the insurance agent newcomer, so that the insurance agent newcomer would give the account to the "insurance black industry team" and "pending order" to use, so as to obtain the excess commission given by the insurance company to the insurance agent newcomer. For Middle-level managers such as Mr. Zhang, they use the convenience of their positions to hang the insurance policy under the name of the insurance agent newcomer, so that the company pays more commissions for the new persons, and from this point of view, it is more appropriate to determine that Mr. Zhang is a job encroachment.
But how to determine the amount of embezzlement? On the basis of comprehensively considering the characterization of the crime and the specific facts, the case-handling team decided to adopt the "theory of special allowance for newcomers", that is, the amount of the newcomer training allowance and the management allowance obtained by them by hanging the insurance policy under the name of the insurance agent as the amount of job embezzlement. Because the original intention of the insurance company to introduce these two allowances is to reward the insurance agent team to develop new people and encourage new people to make more insurance policies, the result is that they are used by the "insurance black industry gang" and the company's "internal ghosts" to illegally obtain the special allowance for newcomers issued by the company. The procuratorial organs finally asked the judicial auditing agency to re-audit the amount of crimes involved in the case.
According to the audit opinion, the amount of Zhang's crime was 180,000 yuan, constituting the crime of embezzlement of office. However, if the principal offenders and other members of the "black industry gang" are idle members of society and do not have the status of official positions, can they be considered accomplices to the crime of usurpation of office? After reviewing previous cases and conducting relevant theoretical research, the case-handling team believes that according to the principle of accomplices, criminal acts committed by taking advantage of the position of one of the parties in a criminal gang can be identified as accomplices to the crime of occupation of office, even if they do not have the status of office. According to the role of Xu Moujia and Zhu Moumou, the two should be responsible for the entire amount of money embezzled by the gang, and the other personnel are respectively responsible for the amount involved in each other.
In December 2020, the Jing'an District Procuratorate approved the arrest of Xu X. A. X. X, Zhu X X, Zhang X X, and others on suspicion of usurpation of office. In the process of reviewing and approving the arrest, the case-handling team also noticed that Zhu Moumou mentioned that in order to accurately "pry orders", he had bought a lot of customer information from the departed employees of the insurance company, whether this behavior constituted the crime of infringing on citizens' personal information, whether Xu Moujia and others were also involved, and the case-handling team listed the direction of the supplementary investigation one by one in the supplementary investigation outline.
It didn't take long for another fact to surface. From March to May 2020, Mr. Zhu, through a matchmaking, purchased a batch of insurance transaction information containing policy number, insurance type, policy amount, customer name, ID card number, etc. from the departed employees of the insurance company, and the above information was directly handed over to the black industry personnel for accurate "pry orders" in Zhongshan, Zhuhai and other places in Guangdong Province; in addition, after Xu Moujia obtained the policy number from other channels, he handed the policy number to xiao X, the insurance company's internal staff, and others. Xiao And others helped to inquire about the detailed insurance transaction information at a price of 50 yuan, and then handed over the policy information to the corresponding personnel for "pry orders". Xiao Moumou and others were immediately arrested by the public security organs.
Research
Frequent occurrence of pending orders was found
The prosecutor appeared in court in support of the prosecution
The crimes of the "black industry gang" and the arrested insurance company "inner ghost" were determined, but the case handling team also found in the process of review that many people suspected of these two crimes had not yet arrived at the case. For example, some insurance agents who know that the "black industry gang" has defrauded the excess insurance agent newcomer commission, some insurance agents who still actively participate in the sharing of the stolen goods and the amount involved in the case has reached the criminal standard, other members of the "black industry gang" who have not yet arrived at the case, and the staff of the insurance company who sell customer information to the "black industry gang", they are also suspected of committing crimes.
After meticulously supplementing the investigation and improving the evidence work, the case-handling team pursued and prosecuted 12 people who were not reported by the public security organs for approval for arrest on suspicion of embezzlement of office and infringement of citizens' personal information, including Xu Mouyi, the principal offender who embezzled 1.84 million yuan from the company involved in the case. On July 9, the Jing'an District Procuratorate indicted Xu Mouyi on suspicion of encroachment on his position.
In the process of reviewing and prosecuting, the case-handling team noticed that many criminal suspects repeatedly mentioned that the phenomenon of "hanging orders" was more common in the industry, so they decided to conduct field research on the insurance industry. Since January this year, the case-handling team has visited the Shanghai Insurance Association and relevant regulatory departments to listen carefully to the opinions of representatives of the Shanghai branch of seven well-known life insurance companies. Through the investigation, it was found that there are also cases of "insurance black industry gangs" in Pudong, Fengxian and other places in Shanghai who defraud commissions by first falsely applying for insurance and then maliciously surrendering insurance. According to the rough statistics of the Shanghai branch of 7 well-known life insurance companies, the economic loss caused by abnormal surrenders during 2020 alone was as high as 102 million yuan.
According to the investigation, the case-handling team wrote the "Investigation Report on the Suspected Crimes of the Black Industrial Chain of Insurance Policy Sales in the Insurance Industry", sorted out the characteristics of the case in detail, deeply analyzed the problems existing in the operation and management of the insurance industry, and submitted it to the Shanghai Municipal Procuratorate, and sent a copy to the Municipal Insurance Association and relevant regulatory departments, which aroused concern.
suggestion
Improve industry compliance operations
Announce the procuratorial recommendation
Held an exchange forum on combating and preventing insurance black industries
The series of "insurance black industry gangs" cases not only seriously affected the interests of the insurance companies involved in the case, but also directly affected the business environment of the entire insurance industry to a certain extent. As a judicial organ, how to prevent and resolve financial risks and create a good business environment while severely cracking down on crimes, the case-handling team on the basis of full communication in the early stage, during the review and prosecution period, respectively, to the Municipal Insurance Association and the insurance companies involved in the case to prepare and issue "Procuratorial Recommendations", and make a public announcement, and at the same time send a copy to the municipal supervision department. On the one hand, it is recommended that the insurance companies involved in the case implement the insured information management and identity verification system; strengthen the identity and performance review of employees; strengthen the management of insurance business accounts; standardize the handling of complaints and surrenders; and increase the intensity of rule of law education for employees. On the other hand, it is recommended that the Municipal Insurance Association establish a "insurance black industry blacklist" system and a case information exchange mechanism to achieve industry-wide information sharing and risk tips, promote industry co-governance; organize insurance institutions to self-examine and self-correct, and achieve industry compliance; increase publicity, improve the public's awareness of the harm of "insurance black industry", and promote mass prevention and group governance. At the same time, the case-handling team will also work with the Municipal Insurance Association and relevant insurance companies to carry out a series of legal popularization lectures for insurance practitioners to prevent and resolve financial risks and insurance fraud.
After the procuratorial recommendations were formulated and issued, the two units attached great importance to and acted quickly, and took targeted measures to improve them. The two units also took the initiative to go to the Jing'an District Procuratorate to deliver a reply to the procuratorial proposal and presented a pennant to show their gratitude.
In order to truly achieve the effect of "handling one case and governing one piece", it is important to crack down on "insurance black property" crimes and increase the publicity of law popularization, and improving industry compliance management is the source of one link, and it is far from enough to rely solely on the strength of procuratorial organs.
To this end, the Jing'an District Procuratorate took the initiative to promote the work in depth. In June, under the guidance of the Fourth Procuratorial Department of the Shanghai Municipal Procuratorate, the court drafted the Opinions on Several Issues Concerning the Handling of Criminal Cases Involving "Insurance Black Property", which summarized in detail the common types of "insurance black property" crimes, criminal methods, and the guidelines and evidence standards for handling cases suspected of different crimes; at the same time, drafted the Implementation Opinions on Strengthening Cooperation and Coordination, Jointly Combating and Preventing Crimes in the Insurance Industry, hoping to build a system at the municipal level by public security, procuratorates, courts, regulatory departments, The cooperation mechanism jointly participated by industry associations and other departments deepens the connection between industry governance and administrative law enforcement and criminal justice, and works together to promote source governance through precise crackdown and effective prevention of "insurance black production", so as to escort the healthy and stable development of the insurance industry. Not long ago, the case was rated as an excellent case (case) of the Shanghai procuratorial organs in implementing the "No. 3 Procuratorial Recommendation".