从“恶意退保”到“买断人伤” 公安部案例揭露保险黑灰产运作

Core Insights - The financial sector has seen significant progress in combating organized crime, with over 1,500 cases reported and nearly 30 billion yuan involved in the last six months [1] - The crackdown has revealed a highly organized and professional nature of insurance fraud, particularly in malicious policy cancellations and collusion with assessment agencies [1][3] Group 1: Financial Crime Statistics - From June to November, nearly 60 operations were conducted, resulting in the dismantling of over 200 criminal gangs [1] - The National Financial Regulatory Administration has transferred over 4,500 leads to law enforcement, involving amounts exceeding 21 billion yuan [4] Group 2: Nature of Insurance Fraud - Insurance black and gray industries have evolved into a complete industrial chain, including false advertising, providing counter-tutorials, and negotiating on behalf of clients [3] - Malicious policy cancellations have been identified as a form of contract fraud, exploiting commission structures to generate profits [6][8] Group 3: Regulatory Response - The regulatory approach has shifted from fragmented efforts to a more coordinated strategy involving both regulatory and law enforcement agencies [5][11] - New regulations, such as the Insurance Sales Behavior Management Measures, aim to curb illegal activities related to policy cancellations [7] Group 4: Case Studies - The case of "Shi and others suspected of contract fraud" illustrates how criminal groups exploit commission systems to create a façade of legitimate insurance transactions [6] - The "personal injury yellow cow" scheme demonstrates the direct erosion of legal integrity in claims processes, with criminals manipulating injury assessments for financial gain [9][10] Group 5: Future Directions - The National Financial Regulatory Administration plans to intensify efforts against illegal loan intermediaries and unauthorized claims agents, maintaining a high-pressure enforcement environment [12] - Financial institutions are urged to strengthen internal controls and risk management to prevent exploitation by black and gray industries [11]