A Taiwanese woman who went to Japan was brutally murdered by a fellow traveler with a knife, which shocked both Taiwan and Japan. Today (27th), the case took a turn, and it was reported that the victim may have been killed by her husband for insurance fraud. In this regard, the Insurance Bureau of the Financial Supervisory Commission stated that this is a criminal case, and the relevant content of the case cannot be disclosed to the public. However, the "Insurance Law" clearly stipulates that four major checkpoints are used to prevent related moral hazards, from solicitation, underwriting, and claims settlement. Once a fraudulent insurance is discovered, the prosecutors will be notified to intervene in the investigation.
As it is currently rumored that the husband of the deceased purchased insurance from multiple insurance companies, including Sanshang Meibang Life Insurance Co., Ltd., regarding the insurance status of this case, Cai Huoyan, deputy director of the Insurance Bureau of the Financial Supervisory Commission, said that due to the non-disclosure of the investigation, it is inconvenient to disclose the relevant content to the outside world.
Regarding the prevention of fraudulent insurance cases involving moral hazard, Cai Huoyan said that first of all, according to Article 16 of the Insurance Law, the applicant has an insurable interest in the life or body of four specific types of persons, including the person or his family members, persons to whom he relies for living expenses or education expenses, debtors, and persons who manage property or interests for himself.
Cai Huoyan said that the insured must have a "specific interest" in the life or body of the insured, otherwise the insurance contract will lose its validity in accordance with Article 17 of the same law. Article 105 of the Insurance Law also stipulates that if a death insurance contract is insured by a third party for another person (the insured), the insured must agree in writing and agree on the insurance amount before the contract will be valid. This provision is mainly to avoid the situation of the insured being insured without the consent of the insured and the insurance being falsely purchased without the consent.
Secondly, in addition to legal requirements, Cai Huoyan pointed out that the insurance industry must pay attention to the "purpose and motivation" of insurance during the solicitation stage. The salesperson should understand why the insurance applicant applies for insurance and record it in the relevant solicitation report or business report as a basis for subsequent evaluation of the rationality of the insurance.
The third line of defense is the "underwriting stage". Currently, in accordance with the Insurance Industry Recruitment and Underwriting Claims Settlement Methods, and the Insurance Industry Recruitment and Underwriting Operations Control Self-Regulatory Standards, insurance companies must report insurance cases to the Association. The query system can know the insured's insurance status and accumulated insurance amount in the insurance company. If the insurance amount or premium reaches a certain standard, financial underwriting and survival surveys will also be conducted to implement the review.
The fourth line of defense is the "claims settlement stage." Insurance companies must follow the "Insurance Industry Solicitation and Underwriting Claims Settlement Measures" and related operating standards, and query the insured's relevant insurance information and accumulated insurance amount through the insurance industry association's insurance notification inquiry system. If the insurance amount or premium reaches a certain standard, further financial underwriting or related investigations must be conducted to confirm whether the insurance amount is equivalent to the financial status of the insured person, and to check whether the motivation for insurance is reasonable. If claims adjusters discover specific evidence of suspected insurance fraud, they should notify the relevant investigation unit to assist in the investigation.
Cai Huoyan emphasized that there are currently many mechanisms to prevent moral hazards.
The Insurance Bureau emphasizes that preventing insurance fraud cannot only rely on the written consent of the insured. It must also understand the purpose of insurance at the solicitation stage, review the accumulated insurance amount and financial rationality at the underwriting stage, and identify suspicious evidence at the claims stage. In order to more effectively reduce moral hazard.
