Documents for fake claims were procured even from places like GB Pant hospital in Delhi and MCD, say probe officials
MEERUT: Trilok Kumar died twice in six months. That is confirmed by official records from two govt institutions. The insurance payout came twice, too.
Days after TOI uncovered an elaborate insurance scam originating in UP and running into hundreds of crores — where insurance agents, claims officials, panchayat authorities and even doctors and bank staff conspired and colluded to insure the dying and sometimes the dead — investigators now say the fraud runs even deeper than initially thought.
They say many more agencies and institutions are involved and that from the initial eight states from which they have nabbed some of the accused, they are now looking at “12 states and counting”.
Cremation Ground receipt of June 19 2024
Six months later, an MCD death certificate surfaced, now claiming Kumar had died on Dec 27, 2024 at Delhi’s Govind Ballabh Pant Hospital. This time it was cardiopulmonary arrest. The paperwork was flawless—stamps, seals, signatures. Hospital records even noted an ECG was conducted before his body was handed over to his family. TOI has the documents in its possession.
Rajiv Gandhi cancer Institute
“You can’t admit a man who’s already dead, run medical tests on him, and then hand over his body — all in a single day,” said Sambhal ASP Anukriti Sharma, one of the lead investigators in a case that has exposed what police in Uttar Pradesh are calling “one of the most calculated and ruthless insurance swindles” in recent memory. “It defies medical logic,” she added. “This wasn’t a clerical oversight. It was a well-oiled fraud machine, siphoning off crores through meticulously fabricated claims.”
Cremation Ground receipt of June 19 2024
A senior doctor at GB Pant Hospital attempted an explanation. “When a patient arrives in the emergency, our focus is to save lives. We do not waste time on formalities. But if scammers manage to convince a patient to provide a false name in exchange for money, with the promise of guaranteed treatment, there is a possibility that the patient may comply. And obviously, the treatment will be done in a fictitious name only.”
Certificate issued by GB Pant Hospital
Dr Goma Ram Chaudhary, chief registrar (birth & death) at MCD, acknowledged the possibility of fake death certificates being issued. He told TOI, “It is possible for a second death certificate to be issued. In a city like Delhi, there may be hundreds of people with the same name. While details like the address, the father’s or husband’s name are recorded, the chances of a certificate being issued again cannot be ruled out, as submitting unique IDs such as the Aadhaar card of the deceased is not mandatory.”
Incorrect Death certificate issued by MCD
There are several cases like Trilok’s. TOI had previously reported (February 8, Insuring the dying and dead: Multi-crore scam running for 7 yrs across 8 states uncovered) that this scam to claim insurance evolved over seven years. It thrived because of the perfect mix of official complacency and policy loopholes. Many insurance companies did not cross-check hospital records or health conditions of individuals, and govt agencies rubber-stamped documents without scrutiny.
Take another case. In Ghaziabad this time, where Sauraj died in Nov 2022, but his death certificate wasn’t issued until Jan 2023. In the interim, two life insurance policies worth Rs 27 lakh were taken out in his name. The payouts were claimed swiftly.
“It is an industrial-scale deception, executed with alarming ease,” an officer involved in the probe that has now extended from UP, where it started, to Delhi, Jharkhand, Bengal, Assam, Madhya Pradesh, Rajasthan, Gujarat, Bihar, Uttarakhand, Haryana, said. “It exploited loopholes in both private and govt-backed insurance schemes, including the Pradhan Mantri Jeevan Jyoti Yojana (PMJJY), which insures the poor for Rs 2 lakh. Unlike private insurers, PMJJY does not require extensive verification. A death certificate alone is enough to process a claim.”
ASP Sharma added, “Since PMJJY does not require thorough nominee verification, fraudsters took out multiple policies, waited 45 days, then forged death certificates to claim payouts. They used different names and took advantage of minimal checks.”
Sharma and the other police officers investigating the multi-state crime spoke about how fraudsters identified even recently deceased individuals, forged documents to backdate policies, and submitted claims that looked airtight on paper. Once the payouts came through, they either kept the entire sum or gave a fraction to the nominee to ensure silence.
When it came to the terminally ill, they posed as financial consultants, preying on their families and convincing them to take out policies under false pretenses. Sometimes, they even paid the premiums themselves, waiting for the policyholder to die before swooping in to collect the payout.
“They would bribe health workers, steal bank details, and collude with local officials,” said a senior investigator.
“Then they’d create a paper trail so seamless that no one would ever question it.”
Sambhal SP Krishan Kumar Bishnoi told TOI, “We have arrested 16 people, including women, so far. And have seized and studied 81 passbooks, 31 fake death certificates, 18 forged rubber stamps of banks, multiple SIM cards, Aadhaar cards, PAN numbers, and other crucial documents. The probe has now expanded to 12 states, exposing a large-scale insurance scam built on fabricated medical records and fraudulent claims.” More arrests are likely to follow soon as those arrested start spilling the beans.
With mounting evidence, police are now expanding their inquiry to include insurance firms, hospital staff, and government officials suspected of facilitating the fraud. Investigators believe thousands of fraudulent claims have already been paid out, with many more currently under review.