The Taipei District Prosecutors’ Office on Thursday indicted a woman and seven of her family members for allegedly defrauding the National Health Insurance (NHI) system by pretending to have mental illnesses.
The amount of money the family is suspected to have defrauded insurance companies is the highest in the system’s history, the prosecutors’ office said, adding that it has suggested the court mete out severe punishment to deter similar behavior.
Prosecutor Huang Pei-yu (黃珮瑜) said she first learned of Chang Yu-chen (張玉真) and her family while attending an insurance seminar in 2018 and thereafter launched an investigation into the matter.
From 2008 to last year, the Chang family allegedly stayed at 11 hospitals and defrauded eight insurance companies by claiming they had symptoms including loss of sleep, hallucinatory hearing, and thoughts of suicide or murder, Huang said.
The claims misled doctors into believing that the family required immediate hospitalization, she said.
However, while staying at a hospital, the family allegedly left to eat, drink, sing at karaoke clubs or go on trips, Huang said, adding that the family members allegedly filed for insurance payouts after they were approved to leave the hospital.
The family allegedly requested NT$5,000 to NT$10,000 (US$165.29 to US$330.58) per day of hospitalization from insurance companies, totaling NT$55.7 million over 11 years, and successfully obtained NT$9.38 million from the NHI to cover “medical expenses,” Huang said.
Chang’s daughter allegedly accounted for NT$12 million in insurance claim payouts, and Chang reportedly demanded NT$50,000 from her daughter per month, Huang added.
Prosecutors said the two allegedly had a falling out over how to split the money, with Chang’s daughter telling Chang over the Line messaging app: “I’m not your Golden Goose. I’ll give you what you are due and no more.”
Chang’s brother-in-law said Chang had faked her insurance claims, and he later allegedly copied her methods to falsify claims, Huang said.
Investigators said they discovered messages on the brother-in-law’s cellphone stating that Chang had been removed from a hospital because she was wearing a lot of jewelry, most of which was paid for through insurance payouts.
Chang told prosecutors that she had resorted to falsifying insurance claims at the suggestion of her insurance agent, surnamed Lin (林), as she was millions of dollars in debt, Huang said.
Lin denied the accusation, prosecutors said, adding that they concluded there was insufficient evidence to show that Lin was involved in the alleged scheme.
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