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Insurance fraud is a serious problem and is dealt with mainly by the mechanisms of civil liability and criminal punishment in China. This article critically examines these mechanisms and their application to different types of fraud, identifies the existing and potential problems with them, and also propose solutions to the problems with reference to the English common law fraudulent claims rule and the Fraud Act 2006 (UK). Chinese Criminal Law provides a unique type of insurance fraud, namely, ‘fabricate insurance subject matter and defraud insurance money’, but no definition of this type of fraud is provided in the Law, this causes judicial difficulty in the trial of the fraud cases. This type of fraud is committed at two stages: ‘fabricate insurance subject matter’ at the stage of conclusion of the contract and ‘defraud insurance money’ at the stage of making claims. It argues that the phrase of ‘fabricate insurance subject matter’ should be construed in a narrow sense that it only refers to the fraud where a non-existent insurance subject matter is fabricated into an existent one; while fabrication of the features or characters of the insurance subject matter should not be taken as the fraud of ‘fabricate insurance subject matter’. This article examines the circumstances under which this type of fraud may be dealt with by civil law or criminal law and puts forward guidelines for the determination of this type of fraud and for the correct application of civil remedies or criminal sanction for the fraud.

Fabricating insurance subject matter and defrauding insurance money: a civil wrong or a criminal offence?