Simon Says: Can you claim your medical bills with a third party’s social insurance card?
This is the thirty-eighth in a weekly series of legal advice provided in a short and entertaining story format.
每周轻松有趣法律常識故事系列 - 第38篇
Keywords: Criminal Offence, fraud, social insurance, insurance fraud, joint crime
Can you claim your medical bills with a third party’s social insurance card?
Jack, a native of Nanjing, is an ordinary laid-off worker. He had been leading a peaceful life. Unexpected that a severe illness struck him recently, and he had to stay in a hospital in Nanjing for a long-term medical treatment. Jack’s bill could not be covered under his rural medical insurance, so he cannot have his hospital treatment expense reimbursed under the Social Security System. Jackson, his son, sighed: "What can we do? We were struggling to make ends meet, but my dear father's illness makes things even worse."
Jack一个土生土长的南京人, 是一个普通的下岗工人。Jack一直过着平静的生活。最近突然发生了严重的疾病, 他不得不留在南京的一家医院接受长期的医疗治疗。Jack的账单不能被他的农村医疗保险覆盖, 因此他不能在社会保险制度下报销他的住院治疗费用。Jackson, 他的儿子, 叹了口气: "我们能做什么？我们一直在努力使收支平衡, 但我亲爱的父亲的病情使事情更糟。
Alex, Jack's relative, is about the same age of Jack and is insured under the medical insurance. Jackson knew this and thought that Alex might be able to help them. Jackson bought a few bottles of good wine and visited Alex. After they had a drink, Jackson burst into tears, "My father is suffering from a serious illness and we don't have enough money, and I can do nothing about it." Then he pleaded,"Please lend me your medical insurance card and certificates, so that I can have my father's medical expenses reimbursed. We are relatives and you must help us." said Jackson with tears in his eyes.
Alex是Jack的亲戚, 大约与Jack同年龄并且有医疗保险。Jackson知道这一点, 并认为Alex可能能够帮助他们。Jackson买了几瓶好酒, 拜访Alex。他们喝了几杯之后Jackson突然大哭起来, "我父亲患了重病, 我们没有足够的钱, 我也无能为力." 然后他恳求, "请借给我你的医疗保险卡和身份证, 这样我就可以有我父亲的报销医疗费用。我们是亲戚, 你必须帮助我们. "Jackson含着泪水说。
Alex was not willing to lend his card at the beginning, however after considering the relationship and thinking of the plight Jack was in, he felt compassionate about Jack and Jackson. Alex thought to himself that the reimbursement wouldn't cause any loss to him and it would be a good thing to help them out of their plight. So Alex agreed to the plan. In this way, Jackson used Alex's identity information to register in the hospital and a month later, with Alex's social insurance card, he got reimbursement of related expenses of 30,000 yuan.
Alex开始不愿意借给他的社保卡, 但是在考虑了Jack的困境之后, 他感到很同情Jack和Jackson。Alex心想, 偿还不会给他造成任何损失, 这将是一件好事, 帮助他们摆脱困境。于是Alex同意了这个计划。这样, Jackson用Alex的身份证及社保卡在医院登记, 一个月后, 他得到了相关费用报销3万元。
When they felt relieved and lucky about it when everything was settled, they got an indictment from the procuratorate, prosecuting Jackson and Alex for fraud.
当一切都解决了, 他们感到宽慰和幸运时, 他们得到了检察院的起诉书, 起诉Jackson和Alex诈骗罪。
Alex felt very innocent and cried, "I never thought of lending my medical insurance card to my relative would be prosecuted."
Alex感到非常无辜, 哭了, “我从来没有想过将我的医疗保险卡借给我的亲属将被起诉。”
Prof Simon Says:
Under China’s Criminal Law, Jackson and Alex have swindled a large amount of medical insurance compensation by making up facts and concealing the truth, causing the loss of public and private property and such acts constitute fraud for “illegal possession of public and private resources” and should be subject to punishment. The court is likely to convict them of joint crimes and impose fines and detention sentences.
在我国刑法中, Jackson和Alex通过欺诈和隐瞒事实, 骗取了大量的医疗保险赔偿, 造成公私财产损失, 这类行为构成对非法占有公众和私人资源, 应受到惩罚。法院很可能将他们的共同犯罪定罪, 并处以罚款和拘留刑。
In our daily life, we should avoid such fraudulent behavior; otherwise we may be punished for commitment of fraud in violation of the China’s Criminal Law.
在我们的日常生活中, 我们应该避免这种“骗保”欺诈行为;否则, 我们可能会因违反中国刑法而被处以诈诈骗罪行。
Criminal Law of the People's Republic of China
Article 266:Those defrauding relatively large amounts of public or private money and property are to be sentenced to three years or fewer in prison or put under criminal detention or surveillance, in addition to fines; or are to be fined. Those defrauding large amounts of money and property or having involvement in other serious cases are to be sentenced to three to 10 years in prison, in addition to fines. Those defrauding extraordinarily large amounts of money and property or involving in especially serious cases are to be sentenced to 10 years or more in prison or given life sentences, in addition to fines or confiscation of property. If cases are governed by other stipulations of this law, those stipulations shall apply.
Paragraph 1, Article 25: A joint crime is an intentional crime committed by two or more persons jointly.
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About the Author: Professor Simon Choi
Prof Simon Choi, solicitor and linguist, is an international lawyer, qualified to practise law in England & Wales and in Hong Kong, China. Simon graduated from law schools of the Peking University, the University of London and the University of Hong Kong respectively, with an in-depth knowledge of Chinese laws and common laws and with more than 20 years experience in China practice and international trade, investment, finance, merger & acquisition. He is an adjunct professor of laws at the Zhongnan University of Economics and Law. Simon is the founding partner of Acme Ardent and can be reached at firstname.lastname@example.org, +86 13823677853, or WeChat ID: simonhkchoi