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Back看中醫詐保金3-2》最強「碰瓷家族」12年受傷500次詐保2800萬 中醫公會發文示警
看中醫詐保金3-2》最強「碰瓷家族」12年受傷500次詐保2800萬  中醫公會發文示警
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自由时报1 hour agoCrime2 min readChinaView translation

看中醫詐保金3-2》最強「碰瓷家族」12年受傷500次詐保2800萬 中醫公會發文示警

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補教老師周約瑟與其妻陳姓保險業務員,2010年至2023年期間向14家保險公司投保意外傷害險,利用中醫診斷特性詐領保險金,12年內受傷500次詐得2800多萬元,換成260根金條,並囤積高價中藥材與保健品,涉及未成年女兒參與詐保行為,案件曝光後引發中醫師公會警告同業防範詐保風險。

AI-generated summary

Why It Matters

周約瑟夫妻長期利用中醫診斷特性詐領保險金,多次以跌倒、夾傷等理由就診,未留明顯外傷,藉此取得診斷證明換取高價中藥材與保健品,累積後申請理賠。

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目前列管的中醫詐保案中,最為矚目的即是55歲補教老師周約瑟與曾擔任保險業務員的58歲陳姓妻子,在2010年至2023年的12年間,密集向14家保險公司投保意外傷害險,並利用中醫診斷特性進行詐保,12年受傷500次詐保2800萬換成260根金條,合計總計額高達2800萬多元。此案促使中醫師公會呼籲同業防範此類詐保操作,以免陷入偽造文書風險。

周約瑟與妻子了解保險業務及實支實付漏洞,二人謀劃出一整套詐領計劃,不但當起一對「碰瓷夫妻」,還把未成年女兒也拉下水;以跌倒、夾傷等理由頻繁前往中醫診所自述手腳挫傷,單一挫傷事故甚至可看診高達132次,女兒跌倒也能看診77次。

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兩人就診時會攜帶行李箱要求配合,因二人「碰瓷」式跌倒,往往無明顯外傷,因此刻意挑上中醫看診,自述傷況後,醫師仍會開一些化瘀藥物,因此都能順利拿到診斷證明,以自費藥品名義換取禮品,囤積燕窩、龜鹿二仙膠、清冠一號等高單價中藥材與保健品,並在累積至理賠上限後,便申請不實證明與理賠

由於周男夫妻原本就是「愛興訟」的個性,過去就與人有不少民、刑事糾紛,夫妻倆朋友不多,後來搬到新北市一處社區,也與鄰居不熟,鮮少人知道他們一家人是靠理賠金過日子。

夫妻靠著「詐保SOP」致富,不但退休過舒服日子,還靠著詐來的保費養育女兒,甚至有計劃地到花蓮買透天別墅、農舍及郊區土地一筆,規劃日後搬到環境好、空氣清新的東台灣安享晚年。

由於周姓夫妻等人每個月大約跌倒、投訴十多次,十年來近千次,是罕見的「申訴大戶」。但不論是向1999投訴,或案件轉至北捷、公車業者處,但都未發現異狀,直到保險公司調查才曝光。

What to Watch

AI outlook — possibilities, not facts

  • 保險公司將完成調查並移送司法單位偵辦詐保犯罪

    Very likely · Within weeks

  • 中醫師公會將加強會員教育與內部稽核,防範類似詐保手法再度發生

    Likely · Within months

Open Questions

  • 具體有多少家中醫診所被涉及?
  • 女兒是否知情參與詐保行為?
  • 保險公司是否將追回已詐領的保險金?

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