Watch Chinese Medicine Insurance Fraud 3-2》The most powerful "Pengci Family" was injured 500 times in 12 years and fraudulently paid 28 million in insurance. The Traditional Chinese Medicine Association issued a warning

Among the TCM insurance fraud cases currently under control, the most eye-catching is that of 55-year-old supplementary teacher Zhou Joseph and his 58-year-old wife surnamed Chen, who once worked as an insurance salesperson. In the 12 years from 2010 to 2023, they intensively purchased accident insurance from 14 insurance companies, and used the diagnostic characteristics of traditional Chinese medicine to conduct fraudulent insurance. In 12 years, they were injured 500 times and fraudulently insured 28 million yuan in exchange for 260 gold bars, with a total amount of more than 28 million yuan. The case prompted the Chinese Medicine Practitioners Association to call on fellow practitioners to guard against such fraudulent insurance operations to avoid the risk of forged documents.

Joseph Zhou and his wife understood the loopholes in the insurance business and out-of-pocket payments, and the two planned a complete fraudulent claim scheme. Not only did they act as a "married couple," but they also dragged their underage daughter into the trap. They frequently visited traditional Chinese medicine clinics for reasons such as falls and pinches to report contusions on their hands and feet. A single contusion incident could even lead to 132 consultations, and the daughter's fall could lead to 77 consultations.

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The two of them would bring their suitcases with them to the doctor and ask for cooperation. Because they fell down and often had no obvious injuries, they deliberately chose a traditional Chinese medicine doctor to see a doctor. After describing their injuries, the doctor would still prescribe some blood-stasis-removing drugs, so both of them could successfully obtain a diagnosis certificate. They exchanged gifts for self-paid medicines and stocked up on high-unit-price Chinese herbal medicines and health care products such as bird's nests, Guiluerxianjiao, and Qingguan No. 1. After the accumulation reached the claim limit, they applied for false certificates and claims.

Because Zhou Nan and his wife were originally "litigious" personalities, they had many civil and criminal disputes with people in the past. The couple did not have many friends. Later, they moved to a community in New Taipei City and were not familiar with their neighbors. Few people knew that their family relied on compensation to live.

The couple got rich by relying on the "fraudulent insurance SOP". Not only did they live a comfortable life in retirement, but they also relied on the fraudulent insurance premiums to raise their daughter. They even went to Hualien to buy a villa, a farmhouse and land in the suburbs in a planned way, planning to move to Eastern Taiwan, where the environment is good and the air is fresh, to enjoy their retirement years.

Because the couple surnamed Zhou and others fall and complain about ten times a month, nearly a thousand times in the past ten years, they are rare "big complainants". However, no matter whether the complaint was made to 1999 or the case was transferred to Beijie or the bus operator, no abnormality was found until the insurance company investigated.