If the suspected amount is too much, it is a crime of fraud.

According to Article 88 of China's Social Insurance Law, if social insurance benefits are defrauded by fraud, forgery of certification materials or other means, the social insurance administrative department shall order it to return the defrauded social insurance benefits and impose a fine of not less than two times but not more than five times the amount defrauded.

Article 89 If a social insurance agency and its staff commit any of the following acts, the administrative department of social insurance shall order them to make corrections; If losses are caused to social insurance funds, employers or individuals, they shall be liable for compensation according to law; The directly responsible person in charge and other directly responsible personnel shall be punished according to law:

(1) failing to perform the statutory duties of social insurance;

(2) failing to deposit the social insurance fund into the special financial account;

(3) withholding or refusing to pay social insurance benefits on time;

(4) losing or tampering with social insurance data and personal rights records such as payment records and social insurance benefits records;

(5) other acts in violation of social insurance laws and regulations.

Extended information:

Behind the "illness" of p>5 people, there is a shocking fraud case of Foshan social security! Luo Wenhao, the former staff member of the Social Security Bureau of Chancheng District, is familiar with the internal loopholes of the Social Security Bureau. By forging false reimbursement materials, he made 5 people "sick" and applied for medical insurance reimbursement, and the "reimbursement" of up to 1 million yuan flowed into his own pocket.

cleverness was outwitted by cleverness, and Luo Wenhao finally caught the news, and his whole family was involved.

On December 4th, 214, the case was heard in the first instance of Foshan Intermediate People's Court, and all five defendants, including Tam Hao, pleaded guilty. The case was not pronounced in court.

According to the information of the prosecution, Luo Wenhao is 31 years old, from Nanzhuang, and was originally a contract worker of the Social Insurance Administration Bureau of Chancheng District, Foshan City. On August 5th, 213, Tam Hao was persuaded by relatives, friends and lawyers to surrender himself to the public security organ, and the truth finally came out.

What is even more shocking is that it is not only one person who has been forged to apply for medical insurance materials. The police finally verified that 5 people were "sick" and applied for medical insurance to reimburse related expenses.

Foshan Procuratorate pointed out that from November 212 to July 213, Luo Wenhao took advantage of his work in the Medical Department of Chancheng Social Security Bureau and became familiar with the reimbursement process of social medical insurance.

Borrowed ID cards from Chen Mou and others on the grounds of helping with social security, and then forged false materials such as medical records and invoice receipts of the above-mentioned people in different places, and submitted them to Chancheng District Social Security Bureau and Nanhai District Social Security Bureau to apply for reimbursement of medical insurance funds for employees and residents, and took them as their own.

It is alleged that Tam Hao * * * used the above means to defraud social medical insurance reimbursement of more than 9.2 million yuan, and another 2.27 million yuan was not paid.

Among them, there were 39 cases of defrauding the Social Security Bureau of Chancheng District, with the amount of * * * amounting to 8.21 million yuan, and 6 cases of false medical expenses amounting to 1.94 million yuan were not paid; Four cases were defrauded by Nanhai Social Security Bureau, with the amount of more than 98, yuan, and another case of false medical expenses of more than 32, yuan was not paid.

according to the description of the medical insurance process provided by the injured unit, it can be seen that according to the system, medical insurance reimbursement must first pass the preliminary examination, review and audit of the handling branch, and then go to the district medical department for review and summary, and then the medical treatment can be paid through the bank.

if the injured unit strictly follows the system, the defendant can't be so easy to get it. In fact, the injured unit is only in the form of review, without substantive review, so it provides loopholes for the defendant's criminal behavior.

Baidu Encyclopedia-People's Republic of China * * * and China's Social Insurance Law

People's Network-The staff cheated 9.2 million social security? 5 people were "sick"