What constitutes insurance fraud?

Legal analysis: Withdrawing insurance funds by fraud, forgery of certification materials or other means constitutes the crime of insurance fraud. Those who defraud insurance money shall be ordered to return it by the administrative department of social insurance, and a fine of not less than two times but not more than five times the amount defrauded shall be imposed.

Legal basis: People's Republic of China (PRC) Social Insurance Law.

Article 87 Where social insurance agencies, medical institutions, pharmaceutical trading entities and other social insurance service institutions defraud social insurance fund expenditures by means of fraud or forgery of certification materials, the social insurance administrative department shall order them to return the defrauded social insurance money and impose a fine of more than 2 times but less than 5 times the amount defrauded; If it belongs to a social insurance service institution, the service agreement shall be terminated; If the directly responsible person in charge and other directly responsible personnel are qualified, their qualifications shall be revoked according to law.

Article 88 Anyone who defrauds social insurance benefits by fraud, forgery of certification materials or other means shall be ordered by the social insurance administrative department to return the defrauded social insurance benefits, and shall be fined at least two times but not more than five times the amount defrauded.