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Author: Lynne Skajaa Publisher: Taylor & Francis ISBN: 1000341402 Category : Law Languages : en Pages : 200
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: Lynne Skajaa Publisher: Taylor & Francis ISBN: 1000341402 Category : Law Languages : en Pages : 200
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: Baris Soyer Publisher: CRC Press ISBN: 1317746236 Category : Law Languages : en Pages : 527
Book Description
This book provides a comprehensive and coherent legal analysis of the impact of fraud on the position of various parties to a marine insurance contract, as well as the cover provided by standard marine policies. The issues under discussion in this invaluable guide are also equally relevant in the context of non-marine insurance contracts. Helpfully divided into two parts; the first part deals with the impact of fraud committed by parties to an insurance contract i.e. the assured, brokers and insurers.The second part analyses the extent to which standard marine policies cover the fraudulent and dishonest activity of third parties to an insurance contract. This book will be of huge practical assistant to practitioners specialising in marine insurance as well as insurance generally, and to professionals, academics and post-graduate students.
Author: Simon Grima Publisher: Emerald Group Publishing ISBN: 183867635X Category : Business & Economics Languages : en Pages : 353
Book Description
In the 18 chapters in this volume of Contemporary Studies in Economic and Financial Analysis, expert contributors gather together to examine the extent and characteristics of forensic accounting, a field which has been practiced for many years, but is still not internationally regulated yet.
Author: Volker Liermann Publisher: Springer Nature ISBN: 3030788296 Category : Business & Economics Languages : en Pages : 362
Book Description
This book, the second one of three volumes, gives practical examples by a number of use cases showing how to take first steps in the digital journey of banks and insurance companies. The angle shifts over the volumes from a business-driven approach in “Disruption and DNA” to a strong technical focus in “Data Storage, Processing and Analysis”, leaving “Digitalization and Machine Learning Applications” with the business and technical aspects in-between. This second volume mainly emphasizes use cases as well as the methods and technologies applied to drive digital transformation (such as processes, leveraging computational power and machine learning models).
Author: American Bar Association. House of Delegates Publisher: American Bar Association ISBN: 9781590318737 Category : Law Languages : en Pages : 216
Book Description
The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
Author: Rebecca S. Busch Publisher: John Wiley & Sons ISBN: 1118179803 Category : Business & Economics Languages : en Pages : 374
Book Description
An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.
Author: Industry Canada Publisher: Competition Bureau Canada ISBN: 1100232400 Category : Business & Economics Languages : en Pages : 45
Book Description
The Canadian edition of The Little Black Book of Scams is a compact and easy to use reference guide filled with information Canadians can use to protect themselves against a variety of common scams. It debunks common myths about scams, provides contact information for reporting a scam to the correct authority, and offers a step-by-step guide for scam victims to reduce their losses and avoid becoming repeat victims. Consumers and businesses can consult The Little Black Book of Scams to avoid falling victim to social media and mobile phone scams, fake charities and lotteries, dating and romance scams, and many other schemes used to defraud Canadians of their money and personal information.
Author: Wendell Potter Publisher: Bloomsbury Publishing USA ISBN: 1608193500 Category : Political Science Languages : en Pages : 289
Book Description
That's how Wendell Potter introduced himself to a Senate committee in June 2009. He proceed to explain how insurance companies make promises they have no intention of keeping, how they flout regulations designed to protect consumers, and how they make it nearly impossible to understand information that the public needs. Potter quit his high-paid job as head of public relations at a major insurance corporation because he could no longer abide the routine practices of the insurance industry, policies that amounted to a death sentence for thousands of Americans every year. In Deadly Spin, Potter takes readers behind the scenes of the insurance industry to show how a huge chunk of our absurd healthcare expenditures actually bankrolls a propaganda campaign and lobbying effort focused on protecting one thing: profits. With the unique vantage of both a whistleblower and a high-powered former insider, Potter moves beyond the healthcare crisis to show how public relations works, and how it has come to play a massive, often insidious role in our political process-and our lives. This important and timely book tells Potter's remarkable personal story, but its larger goal is to explain how people like Potter, before his change of heart, can get the public to think and act in ways that benefit big corporations-and the Wall Street money managers who own them.
Author: Malcolm K Sparrow Publisher: Basic Books ISBN: 0465010741 Category : Political Science Languages : en Pages : 306
Book Description
Who steals? An extraordinary range of folk -- from low-life hoods who sign on as Medicare or Medicaid providers equipped with nothing more than beepers and mailboxes, to drug trafficking organizations, organized crime syndicates, and even major hospital chains. In License to Steal, Malcolm K. Sparrow shows how the industry's defenses, which focus mostly on finding and correcting billing errors, are no match for such well orchestrated attacks. The maxim for thieves simply becomes "bill your lies correctly." Provided they do that, fraud perpetrators with any degree of sophistication can steal millions of dollars with impunity, testing payment systems carefully, and then spreading fraudulent billings widely enough across patient and provider accounts to escape detection. The kinds of highly automated, quality controlled claims processing systems that pervade the industry present fraud perpetrators with their favorite kind of target: rich, fast paying, transparent, utterly predictable check printing systems, with little threat of human intervention, and with the U.S. Treasury on the end of the electronic line. Sparrow picks apart the industry's response to the government's efforts to control this problem. The provider associations (well heeled and politically influential) have vociferously opposed almost every recent enforcement initiative, creating the unfortunate public impression that the entire health care industry is against effective fraud control. A significant segment of the industry, it seems, regards fraud and abuse not as a problem, but as a lucrative enterprise worth defending. Meanwhile, it remains a perfectly commonplace experience for patients or their relatives to examine a medical bill and discover that half of it never happened, or that; likewise, if patients then complain, they discover that no one seems to care, or that no one has the resources to do anything about it. Sparrow's research suggests that the growth of capitated managed care systems does not solve the problem, as many in the industry had assumed, but merely changes its form. The managed care environment produces scams involving underutilization, and the withholding of medical care schemes that are harder to uncover and investigate, and much more dangerous to human health. Having worked extensively with federal and state officials since the appearance of his first book on this subject, Sparrow is in a unique position to evaluate recent law enforcement initiatives. He admits the "war on fraud" is at least now engaged, but it is far from won.
Author: Edward W. Frees Publisher: Cambridge University Press ISBN: 1316720527 Category : Business & Economics Languages : en Pages : 337
Book Description
Predictive modeling uses data to forecast future events. It exploits relationships between explanatory variables and the predicted variables from past occurrences to predict future outcomes. Forecasting financial events is a core skill that actuaries routinely apply in insurance and other risk-management applications. Predictive Modeling Applications in Actuarial Science emphasizes life-long learning by developing tools in an insurance context, providing the relevant actuarial applications, and introducing advanced statistical techniques that can be used to gain a competitive advantage in situations with complex data. Volume 2 examines applications of predictive modeling. Where Volume 1 developed the foundations of predictive modeling, Volume 2 explores practical uses for techniques, focusing on property and casualty insurance. Readers are exposed to a variety of techniques in concrete, real-life contexts that demonstrate their value and the overall value of predictive modeling, for seasoned practicing analysts as well as those just starting out.
Author: Lynne Skajaa
Author: Lynne Skajaa
Author: Baris Soyer
Author: Simon Grima
Author: Volker Liermann
Author: American Bar Association. House of Delegates
Author: Rebecca S. Busch
Author: Industry Canada
Author: Wendell Potter
Author: Malcolm K Sparrow
Author: Edward W. Frees