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Article 159.5 of the Criminal Code of the Russian Federation - insurance fraud. Free answers from lawyers online.
Concept
Insurance fraud is a qualified type of fraud. The commission of this criminal act is possible exclusively in the field of insurance relations - a special type of economic relations, including various types of insurance activities (primary insurance, reinsurance, coinsurance). Insurance in the narrow sense is the relationship between the policyholder and the insurer to protect the property interests of individuals and legal entities (policyholders) upon the occurrence of certain events (insured events) at the expense of insurance funds formed from insurance premiums paid by policyholders (insurance premium).
In accordance with Art. 927 Civil Code and paragraph 2 of Art. 3 of the Law of the Russian Federation “On the organization of insurance business in the Russian Federation” there are two forms of insurance: compulsory and voluntary.
How to protect yourself
Stopping the scam will help you avoid significant difficulties and financial losses. Because even if it is possible to bring the perpetrators to justice, it will take a lot of time. Therefore, it is easier to avoid deception than to try to eliminate the consequences later. Moreover, you just need to be careful so that attackers cannot make money at the expense of a person.
Ordinary citizens can be advised not to immediately agree to interesting insurance conditions, even if they seem very tempting. Because scammers often say one thing, but in reality the person gets something completely different from what he expected. If you wish to conclude an insurance contract, you must re-read it carefully. You should not skip points, even if they seem unimportant. After all, it may contain conditions with which people are deceived.
Firms in general are difficult to deceive because they have already had to deal with unscrupulous clients. They know what to do and always do their due diligence. Therefore, if a person wants to fraudulently obtain funds, then there is a high probability of ending up in court. It’s better not to try to pull off a scam if you don’t want to later pay a large fine or receive a more serious punishment.
Corpus delicti
The disposition of the norm is of a blanket nature; therefore, its application must be preceded by the fact of establishing a specific regulatory framework regulating the relationship between the policyholder and the insurer.
The object of the analyzed crime completely coincides with the generic object of theft - these are social relations that have developed in the field of lending. Like fraud in general, qualified fraud in the insurance industry is always the theft of someone else’s property or the acquisition of rights to someone else’s property through deception or abuse of trust
At the same time, the form of the objective side of the act is strictly limited by the legislator: theft of someone else’s property by deception regarding the occurrence of an insured event, as well as the amount of insurance compensation to be paid in accordance with the law or contract to the insured or other person.
A criminal act is considered completed from the moment the policyholder (other persons) receives an amount of money (goods) not stipulated by the insurance contract, as well as acquiring the legal right to dispose of such money.
The mere fact of provision by the policyholder to the insurer of knowingly false and (or) unreliable information, depending on the circumstances of the case, may contain signs of preparation for fraud in the field of insurance or an attempt to commit such a crime.
Subject is any capable person who has reached the age of 16.
The subjective side is direct, specific intent. The presence of intent to commit fraud in the field of lending may be evidenced, in particular, by the use of fictitious documents.
What to do if you are accused of attempted fraud
It’s one thing when you become a victim of scammers, but they did not have time to complete the matter and took possession of your property. Then you must definitely contact the police at your place of residence and report an attempt to commit a crime. Fraudsters will be convicted and given their due punishment. Often citizens are silent about such facts, because they did not suffer any damage, there is nothing to compensate or return.
The question looks completely different when you yourself are accused of such a crime. First you need to figure out what caused this state of affairs and try to prove your innocence. If the facts speak against you, then the first argument will be the unintentionality of the actions committed. The second is the lack of preparatory measures, without which the attempted crime could not have taken place.
Important! In any case, it will be difficult to prove your innocence. This will require a lot of effort and time, finding witnesses or evidence that you did not do anything criminal
In such a situation, it is best to contact a professional lawyer who will help you understand this difficult matter and advise you on how to proceed. This is the only way you can be sure of a favorable resolution of the issue.
ATTENTION! Due to recent changes in legislation, the information in this article may be out of date! Our lawyer will advise you free of charge - write in the form below. .
Qualification Questions
Insurance fraud committed using an official document granting rights forged by this person is qualified as a set of crimes provided for in Part 1 of Art. 327 of the Criminal Code and the relevant part of the article.
If a forged official document was not used due to circumstances beyond the control of the perpetrator, the offense is qualified under Part 1 of Art. 327 and part 1 of Art. 30 of the Criminal Code, Part 4 of Article as preparation for fraud in the insurance industry.
If a person produced a forged document for the purpose of fraud in the insurance industry, used it for this purpose, but due to circumstances beyond his control was unable to acquire the right to someone else’s property, the act is qualified as a set of crimes provided for in Part 1 of Art. 327, as well as Part 3 of Art. 30 of the Criminal Code and, depending on the circumstances of a particular case, the relevant part of the article.
Insurance fraud committed using a counterfeit official document produced by another person is fully covered by the crime under this article and does not require additional qualifications under Art. 327 CC.
What is fraud
The legislation of the Russian Federation recognizes such a crime as any illegal seizure of someone else’s property for the purpose of profit. According to Article 159 of the Criminal Code of the Russian Federation, such an act can be committed in two ways.
Deception
It can be proven if:
- the victim was told information even though it was known in advance that it contained untruths;
- did not provide important data that could radically affect the transaction;
- an original item that has its own value was passed off as a counterfeit or information was falsified;
- any other actions were taken that could mislead the victim in order to commit the theft of his property.
In practice, there are cases where the accused did not realize that he was committing deception. Such an act is not criminal and is not punishable by law.
Breach of trust
There are a number of reasons that create a favorable environment for the implementation of a criminal plan or attempted fraud:
- the criminals are members of the victim’s inner circle, which is why the transaction is not documented, but is based on an oral agreement;
- a document has been signed assigning certain responsibilities to the parties to the transaction and allowing it to be considered safe;
- the attacker has a certain weight in society or significant material wealth, which creates the illusion of his reliability;
- an advance payment has been made for a product or service, which should guarantee a favorable outcome of the transaction.
In any of the above cases, fraud can be proven if it is completed and the victim loses his property. Otherwise, it can only be classified as unfinished.
Important! Fraud is one of those crimes that is not only difficult to prove, but also difficult to qualify. The victim cannot always figure out the situation on his own and turns to an experienced lawyer for help.
Qualifying features
The law provides for both qualified elements - fraud in the field of insurance, committed by a group of persons by prior conspiracy, as well as causing significant damage to a citizen (Part 2), and especially qualified elements of this crime: firstly, acts committed by the perpetrators using their official position, as well as on a large scale (Part 3); secondly, acts committed by an organized group or on a particularly large scale (Part 4). 14. In relation to the qualifying criteria - a group of persons by prior conspiracy, causing significant damage to a citizen, the perpetrators using their official position by an organized group of persons - see Art. Art. 35, 159. 15. According to note. to Art. 159.1 of the Criminal Code, the article recognizes the value of stolen property as large in size - 1 million 500 thousand rubles, especially large in size - 6 million rubles.
Consultations and comments from lawyers on Article 159.5 of the Criminal Code of the Russian Federation
Since Article 159.5 has a broad interpretation, any person dealing with any insurance company, both commercial and government, can fall under its influence.
Proving the guilt of a subject of a crime who has a really good lawyer and an understanding of Article 51 of the Constitution is not so easy. Lawyers who have dealt with cases under this article in their practice advise contacting lawyers with the same qualifications that the citizen has encountered. For example, if this is the field of auto insurance, then the best solution would be to contact an auto lawyer.
It would be useful to hire two lawyers at once, since the costs of paying them will be covered by the losing party, and the presence of a specialized and general specialist provides an almost 100% guarantee of victory in court.
If a citizen is charged with defrauding an insurance company, you should not use the help of a government lawyer, as he often fails the case and asks the defendant to cooperate with the investigation, sometimes even slandering himself and his loved ones, claiming that it will be possible to “cut down the sentence.”
Even if you lose the trial without admitting your guilt, you can without any problems:
- file an appeal;
- achieve a reversal of the sentence.
The punishment for a crime of this kind is mild, except for obtaining money on a particularly large scale by fraud. It makes no sense to enter into such deals in the first place.
Deception and breach of trust
As mentioned above, these are the two main tools of scammers. What do you mean by deception? It means:
- Hiding the truth.
- Communication of knowingly false information that does not correspond to reality.
- Falsifying data or passing off a counterfeit object as an item of value.
- Other behavior that misleads people.
Breach of trust is used, like deception, for selfish purposes. Quite trusting relationships can exist between relatives, friends, officials and subordinates, and so on. Breach of trust may, for example, manifest itself in the criminal receiving money for a service or work that he allegedly will perform or for goods that he allegedly will deliver after payment.
Where to go for help
Regardless of who was the victim or the type of deception, similar recommendations can be made on where to turn. You should visit one of the following government agencies. You can contact the prosecutor's office if you need proof of illegal actions. Because they can organize an inspection of the insurance company for violations. Based on the results of the examination, it will be possible to make an unambiguous decision.
If a person or company is sure that they have encountered a swindler, then it is worth going to the police. After writing the application, the case will be considered
It is important in this case to prove that an illegal act was committed. Because it is impossible to punish without any evidence of a crime
A company that has evidence of a client’s criminal actions can apply to a judicial authority. A civil case can be filed by the police or the prosecutor's office. A final consideration of the issue will take place in court, after which a decision will be made. If the accused is found guilty, then criminal liability will arise.
Methods to combat fraudsters
The fight against criminal activities in the insurance industry is primarily assigned to law enforcement agencies.
Representatives of insurance companies are also actively involved in the prevention and detection of criminal intentions.
Therefore, the search for fraudsters has recently been carried out quickly and insurance cases are carefully checked before payments are made.
The main methods are divided into those used in external and internal insurance.
External methods include verification of paid insurance materials, as well as contracts concluded with clients. Internal work includes those related to the documentation of insurance companies.
Insurance is often subject to fraudulent schemes, which law enforcement agencies try to prevent.
However, the attackers still want to get money from the insurance company, so they are developing new selfish schemes. Therefore, you need to know the methods of combating them and the main types of such offenses.
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