Article 159 of the Criminal Code of the Russian Federation in the field of insurance. Insurance fraud. Examples of insurance fraud

Objective side and object of insurance fraud

Article 159.5 of the Criminal Code of the Russian Federation provides for criminal punishment for insurance fraud, which is expressed in the theft of property of an insurance organization, the insured or another person, either by deception about the occurrence of an insured event, or by misleading about the amount of insurance compensation. Consequently, the objective side can only be in the performance of the above actions.

To understand the essence of the article under consideration, it is necessary to turn to civil law. According to clause 2 of article 9 of the Law "On the organization of insurance business in the Russian Federation", an insured event means an event provided for by law or an agreement, the occurrence of which is associated with the obligation of the insurer to make insurance payments. For example, the death of a citizen, a fire, an accident, infection with tick-borne encephalitis, reaching the retirement age, etc. can act as an insured event.

According to clause 3 of article 10 of the said Law, insurance compensation (insurance payment) is the amount of money paid upon the occurrence of an insured event. In some situations, its size is determined by law, and in others - by the insurance contract.

Cheating can be passive or active. Passive deception is the concealment of any facts, or deliberate silence about them in order to steal other people's funds. Active deception is the reporting of distorted or false information, the provision of forged documents and other actions aimed at misleading the victim. In most cases, deception is supported by the provision of fake documents - accident certificates, expert or appraisal reports, birth certificates, etc. Some courts consider the provision of forged documents as an independent corpus delicti, while others believe that these actions are a way of committing fraud under Article 159.5 of the Criminal Code. A lawyer specializing in Article 159.5 of the Criminal Code is able to convince the court that the presentation of false documents is a way of committing fraud, and thereby achieve the application of milder sanctions.

The most common examples of insurance fraud are:

provision of incorrect information about the subject when drawing up an insurance policy (for example, hiding information about the presence of serious illnesses in health and life insurance);
distortion of information about the insured event (for example, concealment of the fact that a person not entered in the policy was driving the car injured in the accident);
imitation of the occurrence of an insured event (for example, imitation of an accident);
deliberately unlawful acts aimed at obtaining insurance (for example, killing an insured relative).

The injured party is the insurer, the policyholder, the beneficiary, as well as the insured person. These persons must be connected with the subject of the crime by contractual relationship.

The generic object that the crime encroaches on is property relations, and the direct object is relations in the insurance industry. Since insurance fraud refers to crimes with a material composition, it is considered completed at the moment when the guilty person received someone else's property (money), as well as the right to dispose of this property. In this case, the guilty person may not have time to use the stolen money - for the application of Part 1 of Article 159.5 of the Criminal Code, this will be enough.

The amount of damage during qualification under Part 1 does not matter, except for situations when the value of the stolen property does not exceed 1,000 rubles. In this case, we are not talking about criminal, but about administrative responsibility.

Insurance Fraud Subject

A feature of Article 159.5 of the Criminal Code is that various persons can act as the subject of a crime:

representatives of an insurance organization are employees who work for an insurance company under an employment contract, or direct managers of the organization.
insured - individuals who conclude an insurance contract or have the status of an insured by virtue of the law. The policyholders pay the appropriate premium to the insurer, which is payment for the provision of services.
insured persons - citizens in whose name an insurance contract has been concluded.
beneficiaries - citizens who have the right to count on receiving insurance payments upon the occurrence of an insured event.

All of these persons must meet the requirements of the Criminal Code for the subject of a crime: sanity and their attainment of the age of sixteen.

The subjective side of insurance fraud

Like any other type of fraud, insurance fraud can be committed with direct intent. The subject of fraud is aware that his actions are illegal and may harm public relations, but wants criminal consequences. The motive for fraud under Article 159.5 of the Criminal Code is the desire to get rich at someone else's expense.

Qualified insurance fraud under Article 159.5 of the Criminal Code

Article 159.5 of the Criminal Code also contains qualifying signs of insurance fraud, which include:

Part 2: commission of insurance fraud by a group of persons by prior agreement or causing significant damage to an individual (determined taking into account the property status of the victim, but cannot be less than 5,000 rubles);
Part 3: commission of insurance fraud with the use of official position or on a large scale (from 1,500,000 rubles);
Part 4: commission of insurance fraud by an organized group or on an especially large scale (from 6,000,000 rubles).

Responsibility for committing fraud in the field of insurance under Article 159.5 of the Criminal Code

For the commission of simple fraud in the field of insurance, the legislator has provided one of the following penalties:

a fine of up to 120,000 rubles or in the amount of an individual's annual income;
up to 360 hours of compulsory work;
up to 12 months of corrections;
up to 2 years of restriction of freedom;
up to 2 years of forced labor;
up to 4 months of arrest.

There are no additional penalties for Part 1.

In practice, the accused can count on the most lenient punishment in the presence of mitigating circumstances. Such circumstances, for example, are assistance to the investigation, a confession, the minor age of the accused, voluntary compensation for harm, the commission of insurance fraud due to a combination of difficult life circumstances.

The most severe punishment for part 2 of article 159.5 of the Criminal Code is imprisonment for five years, for part 3 - imprisonment for six years, for part 4 - imprisonment for ten years. The court, in the presence of aggravating circumstances, may apply additional sanctions to the guilty person - a fine or restriction of freedom.

Lawyer under Article 159.5 of the Criminal Code

If you find yourself involved in criminal proceedings under Article 159.5 of the Criminal Code, the support of an experienced lawyer is the first and most important thing for you to enlist. A lawyer under Article 159.5 of the Criminal Code understands not only the intricacies of Criminal and Criminal Procedure Law, but also perfectly knows civil law, which contains rules on insurance. An integrated approach to solving the assigned tasks is an indispensable condition for the work of a specialist.

A lawyer provides legal assistance to a suspect, as well as to an accused at any stage of criminal proceedings. The specialist carefully familiarizes himself with the case materials, reconstructs the picture of what happened, visits the accused in places of detention in order to build an effective line of his defense.

In addition, a lawyer provides the following services to his client:

advising on the application of Article 159.5 of the Criminal Code;
collecting evidence by interviewing witnesses, sending various requests, obtaining documents, etc.;
interaction with the investigation, control over the observance by the investigating authorities of the rights of the suspect or the accused;
appeal against the actions of employees of the investigating authorities;
preparation of documents for participation in criminal proceedings;
defense in litigation;
appeal against judicial acts in a higher instance.

Depending on the circumstances of the case, a lawyer is able to achieve:

an acquittal by a court;
termination of the criminal prosecution of the principal;
termination of the criminal case;
re-qualification of the charge from part 2-4 to part 1 of the article in question;
imposing the lightest possible punishment without applying additional sanctions.

If you are the aggrieved party in an insurance fraud case, the assistance of an experienced attorney is also necessary. The situation is not an exception when the role of the victim is an insurance company with its own staff of lawyers. Firstly, in-house lawyers specialize in other branches of law, and secondly, most of them do not have the status of a lawyer, which allows them to take part in legal proceedings as a defense attorney.

A lawyer under Article 159.5 of the Criminal Code will help:

achieve the initiation of a criminal case;
to bring the guilty person to criminal responsibility;
recover damage from the guilty person.

Therefore, a professional lawyer will help you defend your rights and find the best way out of this situation. Remember that lost time can turn against you, so do not hesitate to contact a lawyer under Article 159.5 of the Criminal Code.

The full text of Art. 159.5 of the Criminal Code of the Russian Federation with comments. New current edition with additions for 2019. Legal advice on article 159.5 of the Criminal Code of the Russian Federation.

1. Fraud in the field of insurance, that is, theft of someone else's property by deception regarding the occurrence of an insured event, as well as the amount of insurance compensation payable in accordance with the law or contract to the policyholder or another person, -
shall be punishable by a fine in an amount of up to one hundred and twenty thousand rubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of up to one year, or by compulsory works for a term of up to three hundred and sixty hours, or corrective labor for a term of up to one year, or restraint of liberty for a term of up to two years, or forced labor for up to two years, or arrest for up to four months.

2. The same act, committed by a group of persons by prior conspiracy, as well as causing significant damage to a citizen, -
shall be punishable by a fine in an amount of up to three hundred thousand rubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of up to two years, or by compulsory works for a term of up to four hundred and eighty hours, or by corrective labor for a term of up to two years, or by compulsory labor for a term of up to five years with or without restraint of liberty for a term of up to one year, or deprivation of liberty for a term of up to four years with restraint of liberty for a term of up to one year or without it.

3. Acts provided for in the first or second part of this Article, committed by a person using his official position, as well as on a large scale, -
shall be punishable by a fine in the amount of one hundred thousand to five hundred thousand rubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of one to three years, or by compulsory labor for a term of up to five years, with or without restraint of liberty for a term of up to two years, or imprisonment for a term of up to five years with a fine of up to eighty thousand rubles or in the amount of the convict's salary or other income for a period of up to six months, or without it and with restriction of liberty for a term of up to one and a half years or without it.

4. The acts provided for in the first, second or third parts of this Article, committed by an organized group or on an especially large scale, -
shall be punishable by deprivation of liberty for a term of up to ten years, with or without a fine in the amount of up to one million rubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of up to three years.

(The article is additionally included from December 10, 2012 by the Federal Law of November 29, 2012 N 207-FZ)

Commentary on Article 159.5 of the Criminal Code of the Russian Federation

1. Corpus delicti:
1) object: main - social relations associated with property relations, regardless of its form; additional - legal relations in the field of insurance;
2) the objective side: theft of someone else's property by deception regarding the occurrence of an insured event, as well as the amount of insurance compensation payable in accordance with the law or contract to the policyholder or another person;
3) subject: a sane natural person who has reached the age of 16;
4) subjective side: characterized by a deliberate form of guilt (direct intent). The perpetrator realizes the social danger of his actions aimed at stealing someone else's property by deception regarding the occurrence of an insured event, as well as the amount of insurance compensation to be paid, foresees the possibility or inevitability of the onset of consequences and wishes for their occurrence.

The crime is considered completed from the moment of committing deception regarding the occurrence of an insured event, as well as the amount of insurance compensation.

The qualifying signs include the same act committed by a group of persons by prior agreement, as well as causing significant damage to a citizen (part 2 of article 159.5 of the Criminal Code of the Russian Federation), as well as the same acts committed by a person using his official position, as well as large size (part 3 of article 159.5 of the Criminal Code of the Russian Federation). A large size in this article is recognized as the value of property in excess of 1 million 500 thousand rubles.

Particularly qualified corpus delicti - the same acts committed by an organized group or on an especially large scale (part 4 of article 159.5 of the Criminal Code of the Russian Federation). A particularly large amount is recognized as the value of property in excess of 6 million rubles.

2. Applicable law:
1) Law of the Russian Federation "On the organization of insurance business in the Russian Federation" (Art. 2 - the concept of insurance and insurance business, Art. 9 - the concept of insured risk and insured event, Art. 10 - the concept of the insured amount and insurance payments, Art. 32.9 - classification types of insurance, etc.);
2) the Civil Code of the Russian Federation (Article 927 - the concept of compulsory and voluntary insurance);
3) Federal Law "On the basics of compulsory social insurance" (Art. 1 - the concept of compulsory social insurance; Art. 6 - subjects of compulsory social insurance; Art. 7 - types of social insurance risks, insured events, etc.);
4) Federal Law "On compulsory social insurance against industrial accidents and occupational diseases" (Chapter 3 - the rights and obligations of insurance subjects, etc.);
5) Federal Law "On compulsory social insurance in case of temporary disability and in connection with maternity" (Article 1.3 - insurance risks and insured events; Chapter 1.1 - rights and obligations of subjects of compulsory social insurance in case of temporary incapacity for work and in connection with maternity and etc.);
6) Federal Law "On compulsory pension insurance in the Russian Federation" (Chapter 2 - participants in legal relations for compulsory pension insurance; Article 8 - insured risk and insured event; Chapter 3 - rights and obligations of subjects of compulsory pension insurance);
7) Federal Law "On compulsory health insurance in the Russian Federation" (Chapter 3 - subjects of compulsory health insurance and participants of compulsory health insurance; Chapter 4 - rights and obligations of insured persons, policyholders, medical insurance organizations and medical organizations, etc.);
8) Federal Law "On compulsory insurance of civil liability of vehicle owners" (Art. 4 - the obligation of vehicle owners to insure civil liability; Art. 5 - the rules of compulsory insurance; Art. 6 - the object of compulsory insurance and insurance risk; Art. 12 - determination of the amount of insurance payment, Art. 32 - control over the fulfillment of insurance obligations by the owners of vehicles, etc.);
9) Federal Law "On the Basics of Tourist Activities in the Russian Federation" (Article 17 - insurance in the implementation of tourist activities);
7 *) acts of the Government of the Russian Federation:
_______________
* Numbering corresponds to the original. - Note from the manufacturer of the database.

Resolution of 07.05.2003 N 263 "On Approval of the Rules for Compulsory Civil Liability Insurance of Vehicle Owners";
- Decree of 24.04.2003 N 238 "On the organization of an independent technical examination of vehicles";
- Decree of 03.11.2011 N 916 "On approval of the Rules for compulsory insurance of civil liability of the owner of a hazardous facility for causing harm as a result of an accident at a hazardous facility", etc.

3. Judicial practice. The cassation ruling of the Moscow City Court of January 16, 2013 in case N 22-368 (Federal Law of November 29, 2012 N 207-FZ enacted Article 159.5 of the Criminal Code of the Russian Federation, which improves the position of a person for committing fraud in the field of insurance, and improves the position of a person, who committed the crime is retroactive).

Consultations and comments of lawyers under Article 159.5 of the Criminal Code of the Russian Federation

If you still have questions about Article 159.5 of the Criminal Code of the Russian Federation and you want to be sure of the relevance of the information provided, you can consult the lawyers of our website.

You can ask a question by phone or on the website. Initial consultations are held free of charge from 9:00 to 21:00 daily Moscow time. Questions received from 21:00 to 9:00 will be processed the next day.

shall be punishable by a fine in the amount of up to one hundred and twenty thousand rubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of up to one year, or by compulsory works for a term of up to three hundred and sixty hours, or corrective labor for a term of up to one year, or restraint of liberty for a term of up to two years, or forced labor for up to two years, or arrest for up to four months.

2. The same act, committed by a group of persons by prior conspiracy, as well as causing significant damage to a citizen, -

shall be punishable by a fine in an amount of up to 300 thousand rubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of up to two years, or by compulsory works for a term of up to four hundred and eighty hours, or by corrective labor for a term of up to two years, or by compulsory labor for a term of up to five years with or without restraint of liberty for a term of up to one year, or imprisonment for a term of up to five years with or without restraint of liberty for a term of up to one year.

3. Acts provided for in the first or second part of this Article, committed by a person using his official position, as well as on a large scale, -

shall be punishable by a fine in the amount of one hundred thousand to five hundred thousand rubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of one to three years, or by compulsory labor for a term of up to five years, with or without restraint of liberty for a term of up to two years, or imprisonment for a term of up to six years with a fine of up to eighty thousand rubles or in the amount of the convict's salary or other income for a period of up to six months, or without it and with restriction of liberty for a term of up to one and a half years or without it.

4. The acts provided for in the first, second or third parts of this Article, committed by an organized group or on an especially large scale, -

shall be punishable by deprivation of liberty for a term of up to ten years, with or without a fine in the amount of up to one million rubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of up to three years.

Comments on Article 159.5 of the Criminal Code of the Russian Federation

Article 159.5 of the Criminal Code of the Russian Federation provides for a special rule on fraud. General signs of theft are discussed in the commentary to Art. 158 of the Criminal Code of the Russian Federation, general signs of fraud and issues of competition of norms on fraud - in the commentary to Art. 159 of the Criminal Code of the Russian Federation.

Responsibility under Art. 159.5 of the Criminal Code of the Russian Federation is provided only for theft by deception regarding the facts directly specified in the law:

a) the occurrence of an insured event;

b) facts affecting the amount of insurance compensation.

In this case, not only the insurer can be deceived, but also, for example, a judge considering a civil case on the recovery of insurance compensation.

Deception involves misleading about specific facts about which a person knowingly provides false information. A crime is characterized by guilt only in the form of direct intent. If a person is mistaken about the amount of insurance compensation due to him, about the obligation of the insurer to pay, the deed does not constitute fraud.

Imitation of an insured event (for example, arson of an insured house, imitation of an accident), if the person did not apply for insurance compensation (for example, the fire department established the true cause of the fire, the traffic police revealed an imitation of an accident), is a preparation for the crime under Art. 159.5 of the Criminal Code of the Russian Federation and entails criminal liability only in the event of a crime committed by an organized group or on an especially large scale (part 1 of article 30, part 4 of article 159.5 of the Criminal Code of the Russian Federation). If, at the same time, with intent or negligence, damage is caused to the property of other persons - the deed can be qualified under Art. Art. 167 or 168 of the Criminal Code of the Russian Federation in the presence of signs of these crimes.

The subject of the crime is common - a sane person who has reached the age of 16.

Large and especially large sizes in st. 159.5 of the Criminal Code of the Russian Federation is understood differently than in Art. 158 of the Criminal Code of the Russian Federation, and are, respectively, one and a half million and six million rubles. Other qualifying features are considered in the commentary to Art. 158 of the Criminal Code of the Russian Federation, the use of official position - in the commentary to Art. 159 of the Criminal Code of the Russian Federation.

Insurance Fraud, that is, the theft of someone else's property by deception regarding the occurrence of an insured event, as well as the amount of insurance compensation payable in accordance with the law or contract to the policyholder or another person - a new specialized norm of the Criminal Code of the Russian Federation. Previously, the composition of this article was covered by the general rule of Art. 159 of the Criminal Code of the Russian Federation (Fraud).

The qualified norm was introduced by the legislator in connection with a significant increase in the facts of fraud in the field of vehicle and real estate insurance.

In accordance with the disposition, this criminal act is possible exclusively in the field of insurance relations... Thus, when initiating a criminal case, it is necessary to analyze the regulatory framework and establish the very fact of the existence of a legally formalized relationship "insured - insurer".

The completed crime can only be considered upon receipt by the subject of the sum insured by deception. The very fact of providing deliberately false documents to the insurance company does not constitute a crime of Art. 159.5 of the Criminal Code of the Russian Federation, however may be qualified under other articles Of the Criminal Code of the Russian Federation (Articles 327, 159 of the Criminal Code of the Russian Federation). A necessary sign of the composition will be intent the guilty person for committing fraudulent actions, its presence may be evidenced, for example, by the presence of forged documents.

The article has a double jurisdiction: the investigative bodies of the Ministry of Internal Affairs of the Russian Federation and the Investigative Committee of the Russian Federation. As in most other cases, the Investigative Committee of the Russian Federation conducts an investigation only on particularly high-profile crimes. A pre-investigation check is carried out by employees of the OEBiPK (OBEP).

Petty fraud (part 1 of the article) does not imply a sanction in the form of a real term of imprisonment. However, the same acts committed as part of a group, causing significant damage to a citizen (part 2 of article) or committed with the use of official position, as well as on a large scale (part 3 of article), provide for imprisonment for up to 4 and 5 years, respectively, with mandatory fines. Acts as part of an organized group or on an especially large scale are punishable by imprisonment for up to 10 years with a fine of up to 1,000,000 rubles (part 4 of Article).

According to the disposition of the article, damage is recognized as large in the amount of at least 1,500,000 rubles, especially large - 6,000,000 rubles.

In 90% of cases, the initiation of this type of case is associated with the so-called auto-fittings and the reimbursement of insurance payments on the facts of staged accidents. The key point in the defense will be both in the field of "economic" cases, and in the field of administrative legislation, the assistance of a car lawyer, in particular, traffic rules and car examination.

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Fraud in the field of insurance art. 159.5. RF Criminal Code