"Cooperate, and you'll get your work injury compensation soon; if not, you won't get a single penny."

A certain HR company inflated injury workers’ “compensation” claims

Transferred from the company’s account to the worker’s account

Then had the worker transfer the received funds

All to Qian’s personal account

Qian then transferred the money back to the company account

After the funds completed circular transfer

The initial transfer records and false agreements

Became the basis for them to defraud the insurance company for high claims

……

“Cooperate, and you’ll get your workers’ compensation soon; if not, you won’t get a penny.” After suffering a work injury, worker Xiao Lei, under pressure from the company’s management, completed an unusual fund transfer: transferring a sum from the company’s account into his account and then transferring it back in full to a designated company account. Later, the initial transfer records were used by the company to apply for workers’ compensation from the insurance company. Recently, the Shanghai Huangpu District Procuratorate filed a public prosecution, and the defendant company and three individuals were lawfully convicted by the court.

In 2020, Ma established a human resources company focusing on providing labor services to container factories. To avoid employment risks, Ma purchased employer liability insurance, agreeing that the insurance company would cover compensation if workers suffered work injuries. From August 2020 to June 2021, multiple workers experienced work injuries, with disability levels ranging from level ten to level seven.

According to normal claims procedures, after a worker sustains a disability, the company should make an initial payment, then, with bank transfer receipts and injury certification, apply for compensation from the insurance company. However, Ma and his partner Zhang had malicious intentions during the claims process: they first signed a compensation agreement with the injured worker for an amount higher than the actual compensation, transferring the inflated “compensation” from the company account into the worker’s account, then had the worker transfer all the money to Qian’s personal account, who then transferred it back to the company account. After the funds completed circular transfer, the initial transfer records and false agreements became their basis for defrauding the insurance company for high claims. They also deliberately concealed the fact that the company had paid workers’ compensation insurance premiums for some employees and had already received payouts, leading the insurance company to unknowingly process duplicate claims.

In early 2024, the insurance company, during routine data review, discovered that in several reported claims, only disability compensation was applied for without medical expenses, which was inconsistent with normal procedures, prompting them to report the case.

On March 3, 2025, the public security authorities transferred the case to the Huangpu District Procuratorate for review and prosecution, suspecting insurance fraud. The prosecuting officers thoroughly reviewed the case files and, after analysis, determined that the insurance proceeds (claims) ultimately entered the company’s account and were owned by the company. The case was classified as a corporate crime, with Zhang, Qian, and the company involved in a joint criminal enterprise.

To accurately determine the amount involved, the procuratorate commissioned a professional forensic accounting firm to audit the flow of funds and the amount of insurance fraud. The audit revealed that the involved HR company defrauded over 490,000 yuan in insurance funds through the above methods. During the review and prosecution process, the prosecutors lawfully informed the three suspects of their litigation rights and explained the leniency policy for confessing and accepting punishment. Confronted with a complete chain of evidence, Ma, Zhang, and Qian all admitted to the fabricated claim process and exaggerated losses to fraudulently obtain insurance money, voluntarily signing confessions and pleas.

Huangpu District Procuratorate believes that the involved HR company and the three suspects have committed insurance fraud. In the joint crime, Ma played a leading role as the main offender; Zhang and Qian participated under instruction, with lesser roles, as accomplices. On September 3, 2025, the case was jointly prosecuted against the HR company and the directly responsible personnel Ma, Zhang, and Qian.

Considering the suspects’ confessions, remorse, and restitution, the court ultimately sentenced them: the company was fined 80,000 yuan; Ma was sentenced to three years in prison; Zhang and Qian received three and one-year prison sentences, respectively, both suspended, and each was fined accordingly.

Source: Procuratorial Daily · Mingjing Weekly

【Source: Hegang Suibin Procuratorate】