Objective: This paper explores the behavioral performance, the generation logic, and the governance path of the insured's medical insurance violations to provide suggestions for the effective supervision of medical insurance funds. Methods: Case analysis and social network analysis were used to analyze cases of medical insurance violations implemented by the insured. Results: Among the 184 cases, the insured were involved in 79 cases of forging false materials, 51 cases of fraudulent use of medical insurance cards, and 36 cases of fabricated medical malpractice facts. As to the governance path, the inspection by the local medical insurance department is the main method, and mass reporting is also an important discovery approach. Recovering medical insurance funds and handing over to the public security department are the main processing outcomes. The Criminal Law and the Social Insurance Law are the main processing basis. Conclusion: The construction of the medical insurance information platform should be further promoted, and the multi-departmental coordination of governance against violations of laws and regulations should be accelerated. The public reporting and reward mechanism should be effectively implemented, and publicity and exposure should be increased. Finally, the legal concept and moral level of the insured should be improved to avoid the prevalence of irrational cognitive mentality.