Life insurance companies in Haryana were in a shock after a series of personal accidental claims followed a set pattern: all those insured would die in road accident within about two months after buying the insurance policy.
Even more, most of the victims were farmers who usually don’t buy such personal accidental life insurance policies and the payments were made ‘online’ using credit or debit cards just about one month before the death of the insured.
Even the nominees in such insurance claims followed the same pattern with their bank, accounts and PAN (Permanent Account Number) card getting processed just a couple of months before the death of the insured.
The coincidences didn’t end here as insurance companies noticed that most of the road accidents in these cases took place in areas falling in the same police stations in Sonepat, Jhajjar, Hisar and Panipat.
As families, doctors and police officers related to these suspected accidental death cases were unwilling to share details, a private investigator appointed by insurance companies expressed doubts that these deaths were accidental.
This made a private insurance company file a complaint with the Director General of Police (Crime) PK Agrawal.
After other insurance firms also filed similar complaints, he handed over the investigation to a Special Task Force. Investigations in the case had led to the busting of a gang whose members were allegedly involved in making fraudulent insurance claims in the name of patients who died of cancer by showing them as road accident victims.
Seven persons, including the kingpin, Pawan Bhoria, have been arrested in this connection. Divulging the modus operandi, a police spokesman said the accused first used to identify cancer patients and contact their family members.
Subsequently, they got the cancer patients insured and after showing their deaths in road accidents, they would help get the insurance claims after lodging FIRs at different police stations in Haryana, he said.
Immediately after this, the treatment record of the deceased person was removed by them from the Post Graduate Institute of Medical Sciences( PGIMS) Rohtak.
In this, government employees like doctors, police personnel and staff of PGIMS Rohtak could be involved, the spokesman said.
As per the police, a Sonipat-based Bhoria used his experience of working for private insurance companies to commit the fraud with the help of family members of cancer patients, policemen, doctors and employees of insurance firms assigned with verifying the accidental deaths.
The gang first used to zero in on last stage cancer patients, convince their family members to buy insurance policies in their names from top firms like IFFCO Tokio, PNB Metlife, LIC, ICICI Lombard, HDFC Ergo, Edelweiss Tokio, Canara HSBC, Kotak Insurance, Max Life, Future Generali, Apollo Munich, Bajaj Allianz, and Aditya Birla Sunlife.
They managed to get these insurance policies without any medical records of the cancer patients being revealed to the insurance firm. As most such patients died within about two months after getting the accidental death insurance policy due to cancer, the gang used to get the body from the family, take it to a spot and crush it with a vehicle to pass it off as an accident.
After this, they used to get a complaint of accident lodged with the help of cops involved in the racket and then the doctors involved in the racket used to help them get fake post-mortem reports giving a reason of death as an accident, thus making a foolproof case for an insurance claim.
To hide the medical history of the patient, the gang used to make hospital staff destroy the original medical records of the deceased in the hospital where they had been treated after registering a fake accident case.
“Normally, they would target patients with throat cancer and would show neck injuries as to a cause of death,” said an official associated with the investigation.
Using accident death certificates, the gang used to file claims from the insurance firms for insured sum, ranging between Rs 8 lakh to Rs 20 lakh. Keeping a part of this amount, the sum was then distributed among family members, police officers, record keepers at hospitals, doctors, insurance agents and others who helped them escape scrutiny.
About 100 people, including doctors at government hospitals, are under the scanner in the scam. The gang is suspected to have executed about 100 cases during the past two years and cheated more than 25 insurance companies of over Rs 100 crore.