The National Medical Insurance Bureau exposed 9 typical cases of defrauding maternity insurance funds

According to the official website of the National Medical Security Bureau on the 2nd, the National Medical Security Bureau exposed 9 typical cases of defrauding maternity insurance funds, so as to remind the majority of insured individuals to participate in maternity insurance through legal channels, provide true, accurate and complete declaration materials to apply for maternity allowances and maternity medical expenses, and jointly maintain the safety of
maternity insurance funds.
The nine typical cases are as follows:

 

1.
The case of Beijing Chaoyang District Insured Beijing Chengqi Technology Co.
, Ltd.
fraudulently obtained maternity insurance funds

 

In February 2020, the Beijing Chaoyang District Medical Security Bureau received the case file
of the Chaoyang District Human Resources and Social Security Bureau on "Beijing Chengwei Technology Co.
, Ltd.
(hereinafter referred to as "Chengwei Company") forging and altering employment relations to defraud maternity allowances" in accordance with relevant procedures.
After careful research and judgment by the Chaoyang District Medical Insurance Bureau and consultation with multiple departments, the case
was reported to the Changying Police Station in Chaoyang District in April 2020.
After investigation and verification by the judicial authorities of Chaoyang District, between March 2017 and October 2019, Chengqi Company used fictitious labor relations to pay employee maternity insurance in the name of employees of Chengqi Company for 36 unemployed women without de facto labor relations, fraudulently obtaining maternity allowances of 987,955.
55 yuan
.
After the case came to light, Chengqi Company refunded
all the maternity allowances fraudulently obtained.
According to the Criminal Law of the People's Republic of China, on July 14, 2021, the Chaoyang District People's Court of Beijing sentenced the eight defendants involved in the case to fixed-term imprisonment ranging from nine months to three years and six months, and imposed fines ranging from 10,000 yuan to 40,000 yuan for fraud
.

 

2.
The case of Zhao'an County Insurance Zhao'an Lamp Network Service Co.
, Ltd.
, Zhangzhou City, Fujian Province, fraudulently obtaining maternity insurance funds

 

In February 2021, the Zhao'an Branch of the Zhangzhou Medical Insurance Center in Fujian Province found doubts
when Zhao'an Lamp Network Service Co.
, Ltd.
declared to receive Huang's maternity allowance.
The Zhao'an Sub-center verified through door-to-door audits, inquiries and investigations of relevant personnel of the company, and sending letters to the tax department and market supervision department to assist in investigation, and confirmed that six insured participants, including Huang Moumou and Shen Moumou, paid basic medical insurance and maternity insurance for employees under Zhao'an Lamp Network Service Co.
, Ltd.
, and had no labor relationship
with the company.
On February 26, 2021, Shen, the person in charge of the company, declared to receive a maternity allowance of 35,750 yuan
on behalf of Huang at the medical insurance service window of the Zhao'an Branch of Zhangzhou Medical Insurance Center.
On March 25, when Shen was applying for the reimbursement of maternity allowance on behalf of Shen, the Zhao'an branch center discovered it in time and refused to give reimbursement
.
According to the Social Insurance Law of the People's Republic of China, the local medical insurance department handled the results as follows: 1.
Recover the maternity allowance of 35,750 yuan that has been issued; 2.
Transfer case leads to the Zhao'an County Public Security Bureau
.
According to the Criminal Law of the People's Republic of China, on September 30, 2021, the Zhao'an County People's Court sentenced the defendant Shen to one year's imprisonment and fined him 8,000 yuan
for fraud.
At present, the lost maternity insurance fund of 35,750 yuan has been fully recovered
.

 

3.
The case of 13 companies including Qingdao Zhongjing Yunchuang Enterprise Management Consulting Co.
, Ltd.
in Qingdao City, Shandong Province, who fraudulently obtained maternity insurance funds

 

In August 2021, the Qingdao Medical Insurance Business Center of Shandong Province found that Qingdao Zhongjing Yunchuang Enterprise Management Consulting Co.
, Ltd.
and other companies had the problem of receiving maternity allowances and the payment base that were quite different, and were suspected of using false labor relations to defraud birth allowances, so they reported the case
to the public security organs.
The Criminal Police Detachment of the Qingdao Municipal Public Security Bureau, the Criminal Police Brigade of the Development Zone Public Security Subbureau, and the Qingdao Municipal Medical Insurance Bureau set up a joint task force to quickly investigate
the case.
After investigation, between April 2020 and September 2021, 17 people involved in the case, including criminal suspect Wang, successively paid basic medical insurance and maternity insurance for employees to Qingdao Shibei District and Huangdao District Medical Insurance Business Center in the name of 13 companies including Qingdao Zhongjing Yunchuang Enterprise Management Consulting Co.
, Ltd.
and Qingdao Jingwujing Automobile Service Co.
, Ltd.
, in the name of 13 companies such as Qingdao Zhongjing Yunchuang Enterprise Management Consulting Co.
, Ltd.
and Qingdao Jingwu Automobile Service Co.
, Ltd.
, to defraud birth allowances
.
At present, the public security department has arrested 17 suspects involved in the case, and the case is being
further investigated.

 

4.
The case of Henan Anbang Human Resources Company fraudulently obtaining maternity insurance funds by Henan Anbang Human Resources Company in Yongcheng City, Henan Province

 

In October 2021, the staff of the Yongcheng Medical Security Bureau of Henan Province found through daily supervision, medical data monitoring, big data analysis and investigation and verification that Henan Anbang Human Resources Company in Yongcheng Dongcheng District falsely declared labor relations without de facto labor relations
with 13 pregnant women.
In view of the seriousness of the case and the suspicion of insurance fraud, the Yongcheng Medical Insurance Bureau transferred the clues of the case to the Yongcheng Public Security Bureau
on October 19, 2021.
The investigation by the Yongcheng Public Security Bureau confirmed that Henan Anbang Human Resources Company had the problem of fraudulently obtaining maternity insurance funds, involving 189,800 yuan
of maternity insurance funds.
According to the Criminal Law of the People's Republic of China, the Yongcheng People's Court sentenced the defendants involved in the case to six months' imprisonment and Xia to one year's
imprisonment for fraud.
At present, the lost maternity insurance fund of 189,800 yuan has been fully recovered
.

 

5.
Dongguan City, Guangdong Province insured Dongguan Sunflower Network Technology Co.
, Ltd.
to defraud the maternity insurance fund

 

In June 2020, the Dongguan Medical Security Bureau of Guangdong Province received clues from relevant departments, reflecting that Dongguan Sunflower Network Technology Co.
, Ltd.
did not pay the maternity allowance to employees in full in accordance with the "Guangdong Provincial Provisions on Maternity Insurance for Employees
".
After investigation and verification, the company had fraudulently reported the salary amount to obtain maternity allowance, and was suspected of fraudulently obtaining maternity allowance of 874,500 yuan
.
The Dongguan Municipal Medical Insurance Bureau transferred the clues of the case to the public security department for further processing
.
According to the Criminal Law of the People's Republic of China, in August 2021, the First People's Court of Dongguan City sentenced the defendant He Moumou to 12 years' imprisonment and fined 50,000 yuan for fraud, and ordered the defendant He Moumou to return 874,500 yuan
to the Dongguan Medical Security Management Center involved within 10 days after the judgment took effect.
At present, the lost maternity insurance fund of 874,500 yuan has been fully recovered
.

 

6.
The case of Shenzhen Kanglu Selenium Textile Co.
, Ltd.
, which was insured in Shenzhen Province, defrauded the maternity insurance fund

 

In August 2021, when the Shenzhen Municipal Medical Security Bureau of Guangdong Province conducted big data analysis, it was found that the insurance period, contribution salary, and maternity allowance amount of 11 insured personnel of Shenzhen Kanglu Selenium Textile Co.
, Ltd.
were abnormal.

After further investigation by the Shenzhen Municipal Medical Insurance Bureau, it was found that Shenzhen Kanglu Selenium Textile Co.
, Ltd.
was suspected of fraudulently applying for 11 maternity allowances totaling 540,000 yuan
by means of fictitious labor relations between June 2017 and April 2018.
In accordance with the Social Insurance Law of the People's Republic of China and other provisions, the Shenzhen Municipal Medical Insurance Bureau handed over the clues of the case to the public security organ for criminal investigation
.
At present, the lost maternity insurance fund of 540,000 yuan has been fully recovered
.

 

7.
Chongqing Shunkun Plastic Products Co.
, Ltd.
fraudulently obtained maternity insurance funds by Chongqing Yuzhong District Insurance Co.
, Ltd

 

At the end of 2019, the Chongqing Yuzhong District Medical Security Bureau found that Chongqing Shunkun Plastic Products Co.
, Ltd.
received abnormal
maternity insurance benefits during business handling.
Through data analysis, it was found that between January 2018 and December 2019, the number of applicants for maternity allowance increased abnormally, and some of the employees had underpaid or had just completed 6 months, and some employees immediately stopped insuring
after applying for maternity allowance.
After the Yuzhong District Medical Insurance Bureau verified the employment, salary payment, employee income, etc.
, as well as the relevant labor contracts, financial statements, accounting vouchers and other relevant materials related to the payment of medical insurance and maternity insurance premiums, and confirmed that the 25 personnel fraudulently obtained maternity allowances by fraudulently obtaining maternity allowances through fictitious labor relations, the Yuzhong District Medical Insurance Bureau transferred the clues of the case to the Yuzhong District Public Security Subbureau for filing and investigation
.
After investigation, 25 personnel of Chongqing Shunkun Plastic Products Co.
, Ltd.
fraudulently obtained 451,800 yuan
in maternity allowance by fabricating labor relations.
According to the Criminal Law of the People's Republic of China, the Yuzhong District People's Court sentenced the three defendants involved in the case, He Moumou, Guo Moumou, and Zhong Moumou, to fixed-term imprisonment ranging from three years, three years, two years and six months to fixed-term imprisonment for the crime of fraud, confiscated illegal gains in accordance with the law, and imposed a
fine.
At present, the lost maternity insurance fund of 451,800 yuan has been fully recovered
.

 

8.
The case of Liu Yuan, an insured person in Hangzhou City, Zhejiang Province, who fraudulently obtained maternity insurance funds

 

In May 2021, the Hangzhou Municipal Medical Security Bureau of Zhejiang Province received a clue from the Hangzhou Medical Security Affairs Acceptance Center under its subordinate Hangzhou, reflecting that the medical invoice of a hospital in Pizhou City provided by the insured person Liu when he declared the maternity medical expenses that occurred in other provinces was suspected of being fraudulent
。 After investigation, Liu had an accidental miscarriage in May 2020, and in order to apply for maternity allowance, he forged medical invoices, discharge records, birth medical certificates and other materials from a hospital in Pizhou City through the Internet, and applied for maternity allowance from the Hangzhou Medical Security Affairs Acceptance Center through his work, defrauding the maternity insurance fund of 25,233.
80 yuan
.
According to the Social Insurance Law of the People's Republic of China, the local medical insurance department handled the results as follows: 1.
Recover the maternity insurance money fraudulently obtained by Liu; 2.
Fined Liu twice the amount of fraud; 3.
Transfer case leads to the public security organs for filing and investigation
.
At present, the lost maternity insurance fund of 25,233.
80 yuan has been fully recovered, and the two-fold fine of 50,467.
60 yuan has been fully received
.

 

9.
The case of Lu Moumou, an insured person in Changfeng County, Hefei, Anhui Province, who defrauded the maternity insurance fund

 

In June 2021, the Medical Security Bureau of Changfeng County, Hefei, Anhui Province, received a tip from the public that Lu Moumou, an insured person in Changfeng County, was suspected of fraudulently obtaining maternity allowances
.
After receiving the tip, the staff of the Changfeng County Medical Insurance Bureau conducted a serious investigation
.
After verification, on March 29, 2019, Lu Moumou fabricated the fact that he gave birth to a female baby in a hospital in Anhui Province, and applied to the Changfeng County Medical Security Fund Management Center for maternity insurance medical expense reimbursement and birth allowance treatment, involving an illegal amount of 23,872.
50 yuan
.
According to the "Social Insurance Law of the People's Republic of China" and other provisions, the local medical insurance department handled the results as follows: 1.
Recover the maternity insurance fund fraudulently obtained by Lu Moumou; 2.
Transfer clues about Lu Mouse's suspected of taking maternity insurance funds to the public security organs; 3.
Give a reward
of 800 yuan to the informant.
According to the Criminal Law of the People's Republic of China, on December 30, 2021, the Changfeng County People's Court sentenced the defendant involved in the case, Lu Moumou, to one year's imprisonment, suspended for one year and six months, and fined 10,000 yuan
for fraud.
At present, the lost maternity insurance fund of 23,872.
50 yuan has been fully recovered
.