电动自行车与机动车发生交通事故不稀奇,可3个月间20多起交通事故,骑行人全都是撞车后坐了个“屁蹲儿”导致尾骨骨折,就太过蹊跷了。
近日,北京警方通报近期破获的一起职业化车险骗保案,目前16名嫌疑人均已被抓获归案。
A string of more than 20 traffic accidents over a three-month period raised red flags for investigators in Beijing — not because of the collisions themselves, but because every case involved an electric bicycle rider falling backward and suffering a tailbone fracture under strikingly similar circumstances.
10余起事故,伤者都是尾骨骨折
2026年4月,人保财险北京分公司依靠公司内部的“蓝盾”反欺诈系统识别出多起异常理赔。经过研判,这10余起理赔都是由机动车与电动自行车发生交通事故造成骑行人受伤引发。
蹊跷的是,伤者的受伤过程和受伤位置高度一致,几乎都是发生剐蹭碰撞后坐了个“屁蹲儿”,导致尾骨骨折,而且,不同事故中的伤者连户籍地都集中在一个地域。
The investigation, which led to the arrest of 16 suspects, began in April when PICC Property and Casualty's internal anti-fraud system flagged a series of unusual insurance claims. These claims all involved accidents between motor vehicles and electric bicycles, with the cyclist suffering a tailbone fracture after a minor collision. What made the cases suspicious was their striking consistency: the injury patterns were almost identical, and the claimants' registered residences were concentrated in the same area.
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随后,保险公司就此情况在行业内进行协同排查,另有多家保险公司也收到了相似的理赔申请。
人保财险北京分公司迅速将线索转递至北京公安经侦部门在该公司设立的“警企服务站”,警方快速响应即刻展开调查。
职业骗保,3个月做了20多次CT
随着警方深入调查,一个以赵某某为首的16人职业化骗保团伙浮出水面。
办案民警介绍,这个团伙的成员都是老乡关系,分工明确、作案手法隐蔽。他们专门选择傍晚或夜间,在人少车少不易被发觉的路段作案,嫌疑人自备机动车和电动自行车,自导自演两车相撞,或设局碰瓷司机,故意制造机动车负全责的虚假交通事故。
As police dug deeper, they uncovered a professional insurance fraud ring led by a man surnamed Zhao. The 16 suspects, all from the same hometown, operated with a clear division of labor, staging accidents at night on quiet roads. They provided the vehicles and either staged collisions themselves or used unsuspecting drivers who were then held fully liable.
“在一起事故中,嫌疑人驾驶机动车在空无一人的道路上向后倒车,另一人骑电动自行车不偏不倚径直向机动车撞去,然后摔倒在地,明显是故意制造事故。”办案民警说。
而骗保成功的关键在于就医过程中上演的“调包计”。该团伙的一名成员齐某某因自身意外摔倒尾骨受伤,就成了现成的“伤员”。伪造事故后,齐某某便被安排冒充事故中的“伤者”去做CT检查。这样一来,就可以拿到“伤者”骨折的医疗证明等相关资料,向保险公司进行理赔。
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“每起事故,该团伙向保险公司申请理赔1万元至3万元不等,拿到保险金后,团伙成员根据各自扮演的角色及作用分赃。”办案民警说,为了每次“验伤”能得到一两千元的好处费,有伤在身的齐某某竟不顾辐射隐患,在3个月里做了20余次CT检查。
The scheme relied on a man surnamed Qi, who had a pre-existing tailbone fracture from an unrelated accident. After each staged crash, he underwent a CT scan, using his old injury to support the insurance claim. Each claim ranged from 10,000 to 30,000 yuan, with Qi receiving 1,000 to 2,000 yuan per case. He underwent more than 20 CT scans in three months.
累计作案20余起,嫌疑人全部抓获
经调查,警方查实该团伙自今年1月至4月间累计作案20余起,向北京地区6家保险公司骗取保险金共计30余万元。在掌握该团伙作案证据后,民警奔赴外省多地将16名团伙成员全部抓获归案。
Between January and April, the group obtained more than 300,000 yuan in fraudulent insurance payouts from six insurance companies in Beijing. Police traveled to multiple provinces to apprehend all 16 suspects, who are now facing criminal proceedings, authorities said.
办案民警介绍,近年来,骗保案件职业化团伙化特征愈发明显,犯罪隐蔽性较强。因此,对骗保违法犯罪的打击重在“快”和“准”。北京公安经侦部门与北京保险行业协会已建立联络机制,民警对企业开展日常走访,了解企业需求,发现风险隐患,并开展有针对性的培训。对于涉保险欺诈犯罪,更是打通了一条快速响应、及时查办的“绿色通道”。
保险公司发现可疑线索后能第一时间转递给警方开展侦查,经侦民警也可以给保险公司提供专业准确的线索排查和取证指导,尽快打击违法犯罪,保护企业和公众的合法权益。
来源:法治日报综合北京日报、北京交通广播
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