Study On The Legal Liability Of Social Medical Insurance Fraud

Social medical insurance fraud has become a typical social disease. It is an inexorable trend to use legal means to regulate it for the future development of social medical insurance against fraud. Legal liability system is the safeguard mechanism of realizing rights and performance of obligation and it is the basic means of the social medical insurance against fraud.This article divided into four parts. The first part is the summarization of social medical insurance fraud legal liability. The section chiefly defines the concept of social medical insurance fraud and introduces the legal nature; analyses the legal nature and the types of fraud legal liability; elucidates the function and value of the legal liability.The second part of the article analysis the civil legal liability of social medical insurance fraud. This part first explores the basic provisions of the civil law in our country and analyses the deficiency of the provisions. On the basis of comparative study on the social medical insurance fraud civil legal liability system, the author put forward to clarify the unjust enrichment of civil liability and introduce the punitive responsibility mechanism. We should also establish and promote qui tam actions in the civil litigation system.The third part is about the elaboration of the administrative legal liability of social medical insurance fraud. This part first discusses the problems existing in the administrative legal responsibility system. By introducing the administrative legal liability provisions of our state, the author suggests to set scientific administrative law enforcement; strengthen the potency dimension of administrative penalties; consummate the responsibility of administrative subjects; use diversified forms of administrative legal liability.The fourth part is about the analysis of criminal legal liability of social medical insurance fraud. Through analyzing the practical experience of the United States, Britain, France, Hong Kong SAR and other countries and regions, combining the actual conditions of China’s criminal legislation, the author suggests perfecting social medical insurance fraud crime legislation by founding "the Crime of Insurance Fraud" and optimizing relevant judicial interpretation.