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What should I do if I am suspected of defrauding insurance because of work mistakes?
Legal basis: Article 87 of the Social Insurance Law of People's Republic of China (PRC), if social insurance agencies, medical institutions, pharmaceutical trading units and other social insurance service institutions defraud social insurance fund expenditures by fraud, forgery of certification materials or other means, the social insurance administrative department shall order them to return the defrauded social insurance money and impose a fine of not less than two times but not more than five times the amount defrauded. If the service agreement is terminated and the person in charge and other directly responsible personnel have the qualification to practice, their qualification to practice 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. 2. Insurance fraud constitutes a punishment for insurance fraud.
Article 198th of the Criminal Law of People's Republic of China (PRC) has one of the following circumstances, which constitutes the crime of insurance fraud. If the amount of insurance fraud is relatively large, he shall be sentenced to fixed-term imprisonment of not more than five years or criminal detention and fined not less than 10,000 yuan but not more than 100,000 yuan, or if there are other serious circumstances, he shall be sentenced to fixed-term imprisonment of not less than five years but not more than 10 years and fined not less than 20,000 yuan but not more than 200,000 yuan, or if there are other particularly serious circumstances, he shall be fined not less than 20,000 yuan but not more than 200,000 yuan or his property shall be confiscated: (1) The (2) The applicant, the insured or the beneficiary fabricates false reasons or exaggerates the degree of loss for the insurance accident that has occurred, thus defrauding the insurance money; (3) The applicant, the insured or the beneficiary fabricates an insurance accident that has never happened to defraud the insurance money; (4) The applicant or the insured intentionally causes an insurance accident of property loss and defrauds the insurance money; (5) Whoever commits the acts listed in Items 4 and 5 of the preceding paragraph, which constitutes other crimes, shall be punished in accordance with the provisions on combined punishment for several crimes. Where a unit commits the crime mentioned in the first paragraph, it shall be fined, and the persons who are directly in charge and other persons who are directly responsible for it shall be sentenced to fixed-term imprisonment of not more than five years, or the amount of criminal detention is huge or there are other serious circumstances, and the amount of fixed-term imprisonment of not less than five years but not more than 10 years is especially huge or there are other particularly serious circumstances, and it shall be sentenced to fixed-term imprisonment of not less than 10 years. If an appraiser, witness or property appraiser of an insurance accident intentionally provides false documents to provide conditions for others to cheat, he shall be punished as * * * insurance fraud.
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