Insurance Intermediary Defraud Insurer

An insurance intermediary in Hong Kong has been found guilty of conspiring with two policyholders in a scheme to deceive an insurer into making accident insurance payouts based on falsified injury claims. The conviction, handed down by the Eastern Magistrates’ Courts on Oct. 31, follows an Independent Commission Against Corruption (ICAC) investigation into alleged fraudulent claims.

Life Insurance Fraud - Lalwani Jay Jerome, 35, who was previously affiliated with Asia One Asset Management Limited as a REFERRER , was convicted on 4 counts of conspiracy to defraud, according to Hong Kong Common Law.

Magistrate deferred sentencing to Nov. 19, pending a background report. Bail was granted for Lalwani, who was ordered to pay restitution of approximately HK$52,000 to the insurer.

According to the court proceedings, Lalwani conspired with two policyholders, Tam Kai-chun and Lam In-kwan, to submit claims for injuries they did not sustain. In 2017 and 2018, Tam and Lam had obtained life insurance policies with accident riders from AIA International Limited through Lalwani, who at the time was working as an insurance referrer. These policies covered medical expenses and injury-related compensation, but claims required documentation such as medical receipts and records of sick leave from licensed medical providers.

Investigation Uncovers Falsified Documents - ICAC investigators discovered that the documents submitted by the policyholders and Lalwani, including medical receipts and sick leave notes, were falsified. Tam and Lam did not, in fact, suffer the claimed injuries nor undergo the stated medical treatments.

Based on these fraudulent claims, the insurer was misled into issuing compensation payments totalling over HK$52,000. Both policyholders, Tam, 37, and Lam, 33, were charged separately by the ICAC for their roles in the fraud and had already pleaded guilty. Their cases are set for mention on Nov. 25.