New Delhi: Nearly 45 days after cancer patient Aslam died in September last year, three men landed at the house of his widow Rukhsar in Uttar Pradesh’s Bulandshahr district. The trio, including Sachin Sharma from the neighbouring Sambhal district, informed Rukhsar that her husband had an insurance policy under which she would receive Rs 1 lakh.
Sachin and his accomplices took copies of Aadhaar and other documents from her to open a bank account for disbursing the compensation.
A few months later, Rukhsar received a call to collect the money from a location on the national highway in Bulandshahr. There, she was handed Rs 50,000 but with a rider: not to reveal anything to the police about the calls, the bank account, or the insurance.
It was only after few days that Rukhsar learnt from the police that SBI Life Insurance had disbursed Rs 15.30 lakh in the bank account opened in her name at Yes Bank’s Anupshahr branch. Turns out, an interstate syndicate was targeting terminally ill patients and even the dead to claim life insurance policies with help from local authorities. Three syndicate members—Onkareshwar Mishra, Amit, Surajpal—are now behind bars, while the Sambhal police are on the lookout for Sachin, the other ringleader apart from Onkareshwar.
Investigators, so far, suspect that the syndicate claimed policies worth over Rs 30 crore from nearly all major insurance companies such as SBI Life Insurance, ICICI Prudential Life Insurance, Canara HSBC, India First Insurance, and PNB Metlife.
The syndicate, according to the Sambhal police, scouted for terminally ill individuals from poor, rural backgrounds for convincing them to purchase government schemes or insurance policies that could cover their treatment expenses.
Help was sought from ASHA health workers and others employed at healthcare centres and pradhans of villages for this purpose, they added.
Gang members then convinced their targets to sign insurance policies and open bank accounts. These brokers even covered the insurance premiums, only to siphon off the lump sum payout from the bank accounts which they controlled.
The fraud did not end there. Even the dead were brought back alive on paper by getting backdated death certificates with the help of local authorities, and policies were issued in their names, Mishra revealed to cops as per the first FIR filed by police in this case.
Sambhal Additional Superintendent of Police Anukriti Sharma, who has overseen the investigation for nearly a month, said that these conmen defrauded hundreds of poor people from Sambhal and neighbouring districts. “The victims are mostly extremely poor and illiterate and who have terminally ill individuals in their family. The accused would convince them that they can help them get some money from government for treatment and if treatment fails, then some compensation,” ASP Sharma told ThePrint.
The accused used to collect the documents such as Aadhaar or PAN card and would pay the premium, she said.
“In the event of death of a policy holder, they would collect additional documents like death certificate but never discloses the actual reason of death to the insurance firms. The nominee would have no idea of the policy or where the account has been opened. The accused had full control of these accounts. When the death claim was approved and money disbursed to these accounts, they would withdraw the money and give a fraction of it to the nominee.”
“In normal cases, these insurance companies would not have approved death claims if they had access to the life assured’s treatment papers,” she further said.
The fraudsters, the Addl. SP said, would also claim policy amounts of people who were no more by submitting fake death certificates.
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Dramatic break
The syndicate was busted courtesy the investigator’s instincts of ASP Sharma, who felt something was amiss when a black Scorpio zipped past a checkpoint set up by the Sambhal Police on the evening of 17 January.
The SUV was stopped, and its occupants, Onkareshwar Mishra and Amit, were grilled as the police found Rs 11.45 lakh in cash and 16 debit cards among others.
From Onkareshwar’s mobile phones, the Sambhal police recovered filled forms of several insurance policies of insurance firms such as SBI Life, ICICI Prudential, Bajaj Allianz, and PNB MetLife were, which, along with WhatsApp chats confirming claims and disbursal of several insurance policies not just in Sambhal but across the country.
“The data received from these insurance companies confirm several policies were issued in states outside Uttar Pradesh, such as Uttarakhand, Delhi, Bihar, Jharkhand and Assam. The way they function and the extent of forgery spotted in only two years of data show this to be an organised act of defrauding big companies, exploiting loopholes and preying on poor people’s vulnerabilities and lack of knowledge,” ASP Sharma told ThePrint.
For identifying potential clients to purchase insurance policies, the syndicate had deployed small groups, scanned district hospitals and rural healthcare centres, and contacted Asha workers to collect data on terminally-ill patients.
To collect data at such a scale, the police said, the syndicate had a huge network of agents and touts who were working at the nominal commission from Onkareshwar and Sachin.
“They collect data such as the name and address of people with terminal illness in a village through primary healthcare centres in the village or from word of mouth marketing,” a police official part of the probe told ThePrint on condition of anonymity.
The syndicate then reached out to the unsuspecting targets through a network of their agents. Since their targets were either dead or terminally ill, they bet on quick returns of their premiums paid for these insurance policies, the police said.
41-year-old Sunita, in her complaint to Sambhal police, said that when her husband Shubhash was ill, a group of men arrived at their house and took their fingerprints and Aadhaar cards to avail an insurance policy that they assured would help in treatment.
Like in the case of Rukhsar, she and her son were summoned to the Babrala area, where they were handed only Rs 20,000. The bank passbook and related demands remained with the fraudsters for obvious reasons.
Fake death certificates of those who died recently were made with the help of gram pradhans, panchayat secretaries and backdated policies issued and the disbursal made in those accounts were swindled off, according to the FIR lodged in the case.
“Since there is not strict verification in the beginning because companies prefer premium at the time of issuance of insurance, these men have been able to get insurance in their targets’ names,” a second police official said.
For “verifying” details of the policy claimants, the insurance companies rope in third-party entities whose employees are tasked with carrying out the investigation.
“They have to investigate the cause of death and history of illness that form the basis of approval or rejection of the sum assured. This is where this organised racket duped the insurance companies,” the second police official added.
Onkareshwar Mishra, the arrested lynchpin, was being roped in by all major life insurance companies in the districts around Sambhal for the verifications. He ensured satisfactory reports to insurance companies following which funds were transferred into the nominees’ accounts, which were under their control.
Police investigation has revealed that the Yes Bank’s Anupshahr branch was used for opening multiple bank accounts. Violation of Know Your Customer (KYC) has also come to the fore, the police said. “Had the KYC been done properly, we could have reached the victims easily with their full address. However, these accounts run by Mishra and his associates were opened with incomplete addresses,” the second police official said.
‘Tip of the iceberg’
ASP Sharma, meanwhile, assembled a team to conduct a reverse search on the policies issued by the busted gang. The team’s investigation led it to several suspicious cases, including that of Rukhsar.
To uncover the full extent of the fraud, the police reached out to insurance firms for data on policies issued to individuals in the region surrounding Sambhal and in which payouts were disbursed based on verification by two companies linked to this syndicate.
“We sought data on the number of policies issued since 2023 and which were claimed within six months of the date of issue, and the cause of death was heart attack,” Addl SP Sharma told ThePrint.
Collation and analysis of data received showed that at least Rs 31 crore had changed hands. SBI Life Insurance was the worst affected, with its disbursal amount coming to approximately Rs 7.27 crore, the police said.
Similarly, PNB Met Life, Canara HSBC and India First had issued policies in excess of Rs 2 crore, Rs 7 crore, and Rs 10 crore, respectively. The policyholders were from states such as Uttarakhand, Bihar, Assam, Delhi, and Jharkhand.
ICICI Prudential, the investigators found, had disbursed over Rs 4.5 crore to its policy holders in Uttar Pradesh in the same period. “These are suspected fraudulent amounts based on data provided by companies and analysed for only two years. The accused have conceded of being involved in these activities for seven years. These numbers are just the tip of the iceberg,” said the first police official quoted earlier.
(Edited by Tony Rai)
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