Integrity Focus

An insurance intermediary, charged by the ICAC, was today (October 31) convicted at the Eastern Magistrates’ Courts of conspiring with two policyholders to deceive an insurer into paying accident insurance compensation to them by making false representations about their injuries. The offence was revealed in the course of an ICAC corruption investigation.

Lalwani Jay Jerome, 35, formerly engaged by Asia One Asset Management Limited (Asia One) as a referrer, was found guilty of four counts of conspiracy to defraud, contrary to the Common Law.

Magistrate Mr Tsang Chung-yiu adjourned the case to November 19 for sentence, pending Laiwani’s background report, and granted him bail. The Magistrate also ordered Laiwani to compensate a sum of about $52,000 to the insurer.

At the material time, insurance broker Asia One was entrusted by AIA International Limited (AIA) to sell its insurance products to customers. When the case took place between late 2017 and June 2018, two policyholders Tam Kai-chun and Lam In-kwan respectively took out an AIA life insurance policy with an accident rider through Laiwani.

The insurance policies covered accident medical expenses reimbursement and accident indemnity. The policyholders were required to submit an accident insurance claim to AIA directly or via Asia One, supported by documentary proof, including receipts of medical consultations or treatments, and sick leave certificates or receipts issued by doctors or physiotherapists.

The court heard that in their applications for insurance claims, Laiwani and the two policyholders falsely represented to AIA that the latter had respectively suffered injuries in his/her back or knees, and attached various documents purportedly issued by two doctors and two physiotherapy clinics to support that the duo had suffered from injuries, attended for medical consultations with the aforesaid doctors or therapists of the physiotherapy clinics, and taken sick leave. As a result, they had deceived AIA into paying insurance compensation totalling at least over $52,000.

The ICAC investigation arose from a corruption complaint. Enquiries revealed that the two policyholders did not suffer from the aforesaid injuries, nor did they receive any treatment or take the sick leave concerned.

The aforesaid policyholders, Tam, 37, and Lam, 33, were also charged by the ICAC for their roles in separate cases. The duo had earlier pleaded guilty and their cases were both adjourned to November 25 for mention.

AIA rendered full assistance to the ICAC during its investigation into the case.

The prosecution was today represented by Senior Public Prosecutor Steven Liu, assisted by ICAC officer Vivian Poon.

The ICAC will continue collaborating with the industry to provide integrity training to insurance intermediaries to enhance their integrity standards. The ICAC collaborated with the insurance industry to compile the “Corruption Prevention Guide for Insurance Companies” which assisted insurance companies in building and strengthening their corruption prevention capabilities in key operational areas such as claims verification. The ICAC will also help insurance companies establish and strengthen their anti-corruption controls/systems. For more information on the ICAC’s preventive and educational services for the industry, please visit the Ethics Promotion Website for the Insurance Industry produced by the Hong Kong Business Ethics Development Centre, and the Corruption Prevention Department’s Corruption Prevention Advisory Service Web Portal.