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Author: Lynne Skajaa Publisher: Taylor & Francis ISBN: 100034052X Category : Law Languages : en Pages : 198
Book Description
Insurance fraud is a growing problem on a global scale. The ABI estimates that fraudulent insurance claims on motor and household policies alone cost insurers in excess of £1 billion every year. This book provides an analysis of the insurance industry’s response to the problem and examines fraud from legal and practical perspectives to determine how to manage and reduce fraud. Key issues covered include: fraud in the insurance and reinsurance context, a look at industry-wide initiatives and individual insurance companies’ approaches to the problem, consideration of recent legal developments and a look at how insurance fraud is tackled in other jurisdictions. Includes a chapter on marine insurance fraud.
Author: Laura Hymes Publisher: John Wiley & Sons ISBN: 1118700872 Category : Business & Economics Languages : en Pages : 292
Book Description
Real case studies on insurance fraud written by real fraud examiners Insurance Fraud Casebook is a one-of-a-kind collection consisting of actual cases written by fraud examiners out in the field. These cases were hand selected from hundreds of submissions and together form a comprehensive picture of the many types of insurance fraud—how they are investigated, across industries and throughout the world. Entertaining and enlightening, the cases cover every type of insurance fraud, from medical fraud to counterfeiting. Each case outlines how the fraud was engineered, how it was investigated, and how perpetrators were brought to justice Written for fraud examiners, auditors, and insurance auditors Other titles by Wells: Fraud Fighter and Corporate Fraud Handbook, Third Edition Edited by Dr. Joseph T. Wells, the founder and Chairman of the Association of Certified Fraud Examiners (ACFE), the world's leading anti-fraud organization, this book reveals the dangers of insurance fraud and the measures that can be taken to prevent it from happening in the first place.
Author: Lynne Skajaa Publisher: Taylor & Francis ISBN: 100034052X Category : Law Languages : en Pages : 198
Book Description
Insurance fraud is a growing problem on a global scale. The ABI estimates that fraudulent insurance claims on motor and household policies alone cost insurers in excess of £1 billion every year. This book provides an analysis of the insurance industry’s response to the problem and examines fraud from legal and practical perspectives to determine how to manage and reduce fraud. Key issues covered include: fraud in the insurance and reinsurance context, a look at industry-wide initiatives and individual insurance companies’ approaches to the problem, consideration of recent legal developments and a look at how insurance fraud is tackled in other jurisdictions. Includes a chapter on marine insurance fraud.
Author: Adolfo Bulleri Publisher: Independently Published ISBN: Category : Languages : en Pages : 182
Book Description
An insurance fraud investigation is a type of fraud investigation that centers around attempts to benefit from deceitful claims. Seeking compensation for false or inflated claims is illegal, dangerous, and raises the price of insurance for everyone. An insurance fraud investigation aids by revealing false claims. Don't let your insurance premiums be a waste of money; use a private investigator to safeguard your insurance privileges. Here's a fascinating-often-time hilarious compilation of insurance fraud cases, some so outrageous, so utterly bizarre and crazy, you'll have a hard time believing them. But it's all true-direct from the private confidential files of one of the nation's top investigators. It represents the best of the best cases the author has handled.
Author: Dr Ruchi Agarwal Publisher: ISBN: Category : Languages : en Pages :
Book Description
Insurance fraud is a complex term understudied in management and governance literature. Insurance fraud consists of policyholder fraud, internal fraud and intermediary fraud. It can be measured at four stages ranging from hard frauds to rampant fraudulent culture. An attention is needed to understand the reasons of rampant fraudulent culture in India. This is the first study (as per author's knowledge) on fraudulent culture in Indian insurance industry that provides broad overview of what insurance fraud is, types of insurance fraud, role of different parties involved, reasons of rampant insurance frauds, strategies adopted and the way forward. The results revealed that direct responsibility of combating insurance fraud is not provided to any institutions, therefore fraud redressal takes a backseat in priorities. Corporates have adopted proactive, reactive and vigilant approaches and used fraud investigation cells, cause and effect analysis and trend analysis to understand the fraudulent culture.
Author: Carolin Hutterer Publisher: GRIN Verlag ISBN: 3668686157 Category : Business & Economics Languages : en Pages : 53
Book Description
Master's Thesis from the year 2017 in the subject Business economics - Miscellaneous, grade: 1,3, LMU Munich (Munich School for Management), course: Executive Master of Insurance, language: English, abstract: The following master thesis covers the psychological drivers of insurance fraud. In this scientific paper it shall be explained how insurance fraudsters try to vindicate their behavior and which forms of reasoning are therefor used. Insurance fraud itself is defined as a fraud to the detriment of an insurance company by the policy holder or a third party with the aim of obtaining unjustified coverage, demanding a false payment of damages on the merits or to the extent of paying a lower insurance premium. The fraudulent behavior starts with consciously inaccurate information during application and extends up to manipulation in the context of loss. The legal consequences of insurance fraud are the same as of any other fraudulent behavior, like a fine or a short period of imprisonment. Furthermore the insurance company can claim indemnity demands or recourse or the insured can lose his coverage. It is reckoned that the annual losses of German insurance sector caused by insurance fraud are four billion Euro and that especially in the line of automobile insurance approximately every tenth notification of claim bases on fraudulent background. About 90 percent of insurance brokers report that they already were in contact with fraudulent clients and a common line in the insurance branch states that each tenth notification of claim contains fraud and that ten percent of payments are based on unjustified or fraudulent declarations. In social context insurance fraud is a damage for all insured clients. A higher rate of fraudulent behavior leads to more payments and in conclusion to higher premiums. The increased niveau of premiums furthermore reduces the public welfare of the insured and often leads to smaller profits for the insurance companies. Thereby many small deceptions have a high impact on the insurance companies, because costs of prosecution of these smaller delicts bear no proportion to the outcome. Basically insurance fraud is not tolerated in society just as any other form of fraud. But on closer inspection and having a regard to the listed numbers concerning insurance fraud it becomes clear, that there exist different standards. In the Europe-wide European social survey 2010 87 percent of respondents declared that insurance fraud is wrong or absolutely wrong.
Author: Barry Zalma Publisher: Independently Published ISBN: Category : Languages : en Pages : 408
Book Description
INSURANCE FRAUD IS EPIDEMIC Insurance fraud continually takes more money each year than it did the last from the insurance buying public. There is no certain number. No one knows the amount that is taken by insurance fraud because most attempts at insurance fraud succeed. Estimates of the extent of insurance fraud in the United States range from $87 billion to more than $300 billion every year. The only certainty is that it is a serious crime that bleeds the insurance industry sufficiently to have states compel insurers to create special investigative units (SIU's) to investigate, deter and defeat insurance fraud to assist the state in its efforts to prosecute the crime. Insurers and government backed pseudo-insurers can only estimate the extent they lose to fraudulent claims. Lack of sufficient investigation and prosecution of insurance criminals is endemic. Most insurance fraud criminals are not detected. Those that are detected do so because they became greedy, sloppy and unprofessional so that the attempted fraud becomes so obvious it cannot be ignored. The National Insurance Crime Bureau (NICB) estimated that almost 25% of the bodily injury claims related to auto crashes are bogus. Property and casualty claims against auto insurance are not much better, coming in at around a 10% fraud rate. The National Association of Insurance Commissioners (NAIC) reports that insurance fraud occurs when an insurance company, agent, adjuster or consumer commits a deliberate deception in order to obtain an illegitimate gain. It can occur during the process of buying, using, selling, or underwriting insurance. Insurance fraud may fall into different categories from individuals committing fraud against consumers to individuals committing fraud against insurance companies. Non-medical insurance fraud is estimated at over at $40 billion dollars per year. Fraud not only inflicts extra costs on insurance companies, but it also financially impacts consumers, costing the average U.S. family between $400 and $700 per year in premiums. When insurers and governments put on a serious effort to reduce the amount of insurance fraud the number of claims presented to insurers and the pseudo-government-based or funded insurers drops logarithmically. Insurance fraud is not limited to the US. In Britain fraud costs the British economy amounts estimated in billions of British pounds. Since the amount of fraud actually detected is a small portion of what was actually found, the estimates published are little more than an educated guess. Vendors and organizations include the Coalition Against Insurance Fraud (CAIF), CSC, Detica NetReveal, Equifax, Experian, FICO, IBM, Innovation Group, Insurance Bureau of Canada (IBC), ISO/Verisk, KPMG, LexisNexis, FastCase, Mattersight, Mitchell, the National Insurance Crime Bureau (NICB), SAP, SAS, and TransUnion. No matter how seriously the insurers work to prove fraud the authorities often ignore them. In response, police and prosecutors complain that the insurers do nothing that police and prosecutors can use to prosecute the crime of insurance fraud while insurers complain that prosecutors ignore them when they present evidence of a fraud. There is truth in both complaints. Insurers, although compelled by statute to investigate potential insurance fraud and to present the results of their investigations to prosecutors, they are not trained as police officers. Insurance company employees, whether claims adjusters or SIU investigators are not trained to present evidence of a crime to a court. They can only advise professional insurance fraud investigators at the state departments of insurance or state police agencies who must then investigate further to obtain evidence that is sufficient for a charge of insurance fraud or to convince a Grand Jury to issue an indictment.
Author: Robert Tillman Publisher: UPNE ISBN: 9781555533755 Category : Business & Economics Languages : en Pages : 230
Book Description
As the costs of medical care have skyrocketed, so has the amount of money lost to fraudulent health insurance providers. These bogus operations typically victimize individuals on the lower end of the socioeconomic scale who then face staggering medical bills without coverage. Robert Tillman shows how market conditions and weak regulatory structures have allowed these crimes to occur, and cites recent institutional and legal changes that have created both new demands for insurance and greater opportunities for fraud. He also analyzes the political and economic climate that enables these criminal practices to flourish. Drawing on court documents, congressional hearings, and actual cases, Tillman provides numerous examples of the three most prevalent forms of fraud: scams involving multiple employer welfare arrangements, employee leasing schemes, and fictitious labor unions. He also examines recent innovations in insurance fraud such as "24-hour plans" and coverage offered by dubious religious organizations. With the regulation of health insurance currently in chaos, Broken Promises offers a critical examination of this insidious form of white-collar crime. It is a timely book that raises important questions about the definition of insurance and consumer protection.
Author: Tony Baldock Publisher: ISBN: 9780642240286 Category : Insurance crimes Languages : en Pages : 6
Book Description
The nature and extent of insurance fraud in Australia is examined. The steps being taken by the insurance industry to prevent fraudulent claims, notably the creation of the Insurance Reference Service, are discussed, as are efforts by the Australian police services. The insurance fraud situation and fraud prevention strategies in the USA are also outlined.
Author: Barry Zalma Publisher: ISBN: Category : Business & Economics Languages : en Pages : 290
Book Description
The state of California compels all who are even tangentially involved in the claims process to comply with and have training in the Fair Claims Practices Regulations (Regulations) and the Integral Anti-Fraud Personnel Regulations (SIU Regulations). It is necessary that those insurance agents and other persons who are engaged in any way in the presentation, processing or negotiation of insurance claims in the state of California be familiar with Regulations imposed by the state of California on all insurers doing business in the state. This book and its appendices will enable insurers to effect compliance with the Regulations when training or assisting claims personnel in their obligations to read and understand the Regulations. The Appendices include an outline for an insurance company staff member, trainer, or lawyer to use in conducting a training class to all of the insurer's integral anti-fraud personnel. Zalma provides insurers and their staff the information needed to comply with California SIU Regulations and the tools to train others to do the same.
Author: Lynne Skajaa
Author: Laura Hymes
Author: Lynne Skajaa
Author: Adolfo Bulleri
Author: Robert Tillman
Author: Dr Ruchi Agarwal
Author: Carolin Hutterer
Author: Barry Zalma
Author: Robert Tillman
Author: Tony Baldock
Author: Barry Zalma