the following 14 situations are medical insurance fraud. 1, allowing or inducing non-insured individuals to be hospitalized in the name of the insured. 2. The medical expenses that should be paid by the insured individuals at their own expense shall be declared to the medical insurance fund for payment. 3, hanging bed in the hospital or will be able to outpatient treatment of insured individuals admitted to the hospital. 4, the use of repeated registration for the insured individuals, repeated or no indication of treatment, decomposition of hospitalization and other ways to transition medical care or provide unnecessary medical services. 5, in violation of the provisions of the scope of medical insurance drugs or drug varieties, to over-medication, repeated medication, illegal use of drugs with special restrictions, or to decompose, change the prescription, etc. for the insured individual dispensing. 6. The expenses incurred by non-designated medical institutions are merged into the expenses of designated medical institutions and settled with medical insurance agencies. 7, to assist the insured individuals to take medical insurance personal account fund or overall fund. 8, without authorization to raise fees, increase fees, fees decomposition, repeated charges, expand the scope of charges and other illegal charges. 9, resort to deceit, false data, etc. to obtain medical insurance funds or personal account funds. 1. Selling drugs for non-designated drug business units and brushing social security cards on their behalf. 11. Swapping expenses such as drugs, diagnosis and treatment items, medical materials, medical service facilities or daily necessities, and health supplements outside the scope of medical insurance payment for expenses within the scope of medical insurance policy, applying for medical insurance settlement, and taking funds to pay. 12, forging or using false medical records, prescriptions, inspection report, disease diagnosis certificate and other medical documents to defraud the medical insurance fund. 13, the use of false medical bills for reimbursement. 14, other violations of social insurance related regulations, resulting in the loss of medical insurance fund behavior. The following acts belong to traffic accident insurance fraud: 1. False materials provide false claim materials for insurance fraud. For example, after the criminal suspect insured a car that didn't actually exist, he reported an insurance accident in the field and killed one person. Provide traffic police accident confirmation, mediation, death certificate, medical records and other documents and materials, and make claims. After investigation, all the above materials were forged evidence. The most common case in this kind of case is that the case does happen, but it provides false salary, lost work, nursing certificate, household registration nature certificate, community village Committee and other relevant certificates to obtain high compensation. 2. Forge an accident. Forge an accident for insurance fraud. This situation is the most prominent in auto insurance fraud, and most of them are collusion between the insured (owner) and the repair shop or the repair shop hides it from the insured (owner) and forges the accident by itself to carry out insurance fraud. It is mainly to create false traffic accidents with vehicles to be repaired, artificially expand the damage degree of vehicles, and then falsely report maintenance costs to defraud insurance companies of claims. 3 The fake car owner forged the fake ID card of the car owner and went to the door to defraud. This situation is nothing more than three possibilities: first, the owner colludes with his associates or gangs to defraud; Second, repair agencies and agencies implement gang fraud; Third, insurance companies collude inside and outside to defraud compensation. 4 Replace the driver for drunk driving or driving without a license, and replace the driver to illegally evade responsibility. This situation mostly exists in traffic accidents at night. In case of an accident due to drunkenness, drunkenness or driving without a license, replace it with a person who has not drunk and is qualified to drive, so as to obtain compensation. Take risks first, then insure; take risks first, then insure, and then insure after a traffic accident or robbery accident. This kind of case is generally an accident with a large amount of money in a short period of time after the insurance takes effect, such as theft, robbery, overturning and other accidents with large losses. 6 deck car out of danger deck car out of danger. This kind of case mainly exists in operational trucks, and often several cars apply a license plate and * * * use a policy. Article 198 of the Criminal Law of the People's Republic of China commits insurance fraud under any of the following circumstances, and if the amount is relatively large, it shall be sentenced to fixed-term imprisonment of not more than five years or criminal detention, and shall also be fined not less than 1, yuan but not more than 1, yuan; If the amount is huge or there are other serious circumstances, he shall be sentenced to fixed-term imprisonment of not less than five years but not more than ten years, and shall also be fined not less than 2, yuan but not more than 2, yuan; If the amount is especially huge or there are other particularly serious circumstances, he shall be sentenced to fixed-term imprisonment of not less than 1 years, and shall also be fined not less than 2, yuan but not more than 2, yuan or his property shall be confiscated: (1) The applicant intentionally fabricates the subject matter of insurance to defraud the insurance money; (2) The applicant, the insured or the beneficiary fabricates false reasons or exaggerates the degree of loss for the insurance accident, thus defrauding the insurance money; (3) The applicant, the insured or the beneficiary fabricates an insurance accident that has never happened to defraud the insurance money; (4) The applicant or the insured intentionally causes an insurance accident that causes property losses and defrauds the insurance money; (5) The applicant or beneficiary intentionally causes the death, disability or illness of the insured to defraud the insurance money. Whoever commits the acts listed in Items 4 and 5 of the preceding paragraph and constitutes other crimes shall be punished in accordance with the provisions on combined punishment for several crimes. If a unit commits the crime mentioned in the first paragraph, it shall be fined, and the directly responsible person in charge and other directly responsible personnel shall be sentenced to fixed-term imprisonment of not more than five years or criminal detention; If the amount is huge or there are other serious circumstances, he shall be sentenced to fixed-term imprisonment of not less than five years but not more than ten years; If the amount is especially huge or there are other especially serious circumstances, he shall be sentenced to fixed-term imprisonment of not less than 1 years. If an expert witness, witness or property appraiser of an insurance accident intentionally provides false documents to provide conditions for others to cheat, he shall be punished as a * * * offender of insurance fraud.