Key accused in inter-state insurance fraud, 2 bank officials held: Sambhal cops

“The Rajpura police of Sambhal district for over a month now has been working towards busting an inter-state gang, called the insurance mafia gang,” Sambhal SP Krishana Kumar Bishnoi said, adding that the gang operates in 12 states, including in UP, Rajasthan, Delhi and Jharkhand. On Thursday, two passbooks, a cheque book, a debit card, an insurance policy claim form, a bank letterhead, photocopies of passbooks and other documents of different banks were recovered, he said.

The SP said that Shailendra Kumar was the investigating officer and head of the East India Company, which was paid Rs 5,400 for on-the-ground verification of each insurance claim.

“The main insurance companies had trusted Kumar but we have learnt that he has processed nearly 200 to 250 such false insurance policies and has grabbed around Rs 10-20 lakh. We have also arrested two deputy managers of a private bank in this case,” said Bishnoi.

Bishnoi said that the investigation team was led by Additional SP, Sambhal, Anukriti Sharma, adding that 15 people have been taken into custody so far. The gang collects information of the deceased either from their family members or through ASHA workers and other agents of the gang work on the ground level, he said.

“In the name of providing families the benefit of certain government schemes, their details are taken and bank accounts are opened. The family members are unaware their bank accounts have been opened and an insurance policy of the deceased is bought from several companies by showing them alive,” said Bishnoi.

This was the third series of arrests in the case since Saturday.

“We had recovered 81 passbooks of various banks, 16 cheque books, 35 debit cards, 25 Aadhaar cards, 18 PAN cards, 51 insurance policy claim forms, 31 death certificates, 17 insurance policy bonds, 12 photocopies of insurance policies, two laptops, five mobile phones, seven SIM cards, 18 seals of various banks and a metro train card,” said Sharma.

How did the case unfold?

On January 17, Additional SP Sharma was heading home when an SUV zipped past her. The rash driving made her suspicious and she asked the driver, Omkareshwar Mishra Karan, a resident of Banaras, to stop but he fled. Sharma alerted the police patrol and a roadblock was set up to intercept the car.

At the Sambhal naka, the police nabbed Omkareshwar and recovered `11.45 lakh in cash and 19 debit cards — the scam began to unravel.

“Following the interrogation, we found that they were duping people using fake insurance policies through fake claims and creating multiple death certificates and other related documents,” Sharma told The Indian Express.

On January 18, Omkareshwar and Amit Kumar, both employed by two investigation agencies — First Solution services and East India Company — were arrested, Sharma said, adding that Neelam, 40, an ASHA worker, a resident of Bulandshahr, was also arrested. The companies investigate death claims sent to them by insurance companies, she said.

An FIR was filed naming 12 people and the action led to victims who were duped coming forward. Later, six more FIRs were filed after analysing the data from insurance companies, said Sharma.

Modus operandi

Sambhal SP said the gang also claimed insurance under PM Jeevan Jyoti Bima Yojana (PMJJY), in which those eligible can claim Rs 2 lakh.

They filled out claim forms with death certificates and other necessary documents and submitted it to the banks where the deceased had accounts.

According to the SP, the gang collected information about severely ill people in the villages. “This was mainly done by the ASHA workers who got their commission. Usually, 45 days are needed from when a person dies and claiming the insurance. They first enroll people (who are dead) for insurance, become their nominee and keep the passbooks to show that premiums have been paid. In most cases, the nominee account is opened after the death,” he said.

ASP Sharma said, “The gang insured those who were dead. In September, an insurance account was opened in the name of a person who had died in June. They prepare a fake death certificate… created an entire scene to show the person was admitted to a hospital, and created a fake ECG report and prescriptions. They prepared a new date of death of the person to claim the insurance of multiple policies, in case they are caught in one.”