While workplace injury rates in Hong Kong have stabilised, a more “shadowy” crisis is emerging: compensation fraud. The Hong Kong Federation of Insurers (HKFI) estimated in 2021 that 10% to 15% of all claims may contain fraudulent elements, and in the first half of 2025, complaints of fraudulent cases were up by 33% year-on-year. This has contributed to a staggering HK$1.8 billion underwriting loss in employee compensation insurance in recent years.
Hong Kong’s labour market is currently battling a sophisticated “injury-for-profit” industry, ranging from exaggerated personal injuries to professional “claim syndicates”. This insurance claims investigation case study – drawn from our own work – shows how field surveillance can cut through the lies and expose organised fraud.
The "Hospital Lurker" in Action
To understand how these syndicates operate, one must look at the “recruitment” process that often happens in plain sight within our public hospitals.
A few years ago, our investigators shadowed a middle-aged man who claimed to have slipped at work, suffering hip and leg injuries. During early field surveillance, he showed no visible walking difficulties. However, the turning point occurred at the hospital’s Department of Orthopaedics & Traumatology (O&T). A “friendly” woman in casual wear approached him; they spoke for 20 minutes before boarding a taxi together toward Central.
They entered a modern office building and visited a law firm. One hour later, the transformation was complete: the man who had walked in normally emerged with a heavy limp and a dark, suspicious look. By his next checkup, he was using a walking stick and appeared highly alert to any surveillance in the vicinity.
This was no medical setback — it was the direct result of “ambulance chasers” instructing a patient to act more “injured-alike” to fabricate evidence for higher payouts.
What is most alarming is that, as we handled more and more cases, we kept seeing the same “familiar faces” in the hospital. Even more troubling, some of these patients ended up at the same law firms. This revealed an inconvenient truth: some corrupt law firms were earning money by manipulating insurance claims submitted by both “genuine” and “fake” patients.
Why this matters: without professional field surveillance and insurance claims investigation, these patterns would remain invisible to insurers and employers.
The True Cost: Champerty, Maintenance, and Financial Loss
These corrupt law firms and their agents operate through Champerty and Maintenance – illegal practices that fundamentally undermine the justice system and the welfare of the injured.
While the law is designed to protect workers and ensure they receive the compensation they are rightfully entitled to, these syndicates prioritise their own profits. By illegally exaggerating injuries to secure higher payouts, the syndicate ensures they take a significant cut of the final settlement.
For a genuinely injured person, this means their actual compensation is siphoned off, potentially leaving them with insufficient funds for their true medical expenses. Ultimately, this predatory cycle creates immense financial pressure across Hong Kong’s entire corporate and insurance landscape, driving up costs for everyone.
The Solution: Surveillance as the "Trump Card" in Insurance Claims Investigation
To combat “injury-for-profit” syndicates, covert field surveillance is the key to solving these mysteries. High-quality surveillance footage – a cornerstone of any thorough insurance claims investigation – provides:
- Proof of actual mobility – contrasting a claimant’s private behaviour with their “public” performance.
- Deterrence: – providing evidence of injustice that can deter wild expectations of “handsome” compensation;
- Informed decision-making – allowing insurers and employers to separate genuine claims from organized fraud.
Insurance claims investigations is not just about reviewing paperwork, it is about delivering court-admissible, objective evidence that stands up to scrutiny. When combined with field surveillance on claimants and related parties, it becomes a powerful shield against fraudulent payouts.
Protect Your Organisation
At Herald, we specialise in insurance claims investigations that help insurers, law firms, and employers identify the truth. Our experienced investigators are trained to conduct discreet, legally compliant stakeouts, background checks and field surveillance.
Ready to stop fraud before it costs you millions? Contact our team today for a professional consultation.
