Professional Documents
Culture Documents
of the economy and is growing at the rate of 15-20 per cent annum.
The origin of life insurance in India can be traced back
to 1818 with the establishment of the Oriental Life Insurance Company in Calcutta.
deception made for personal gain or to damage another individual; the related adjective is fraudulent.
The specific legal definition varies by legal
jurisdiction.
BUSINESS FOR CRIMINALS WHO FIND IT VERY EASY TO PLANT EVIDENCE AND DEMAND INSURANCE COVER FOR ANY DAMAGES OR LOSS THAT IS INTERNATIONALLY CARRIED OUT.
INSURANCE FRAUDS ARE FOUND IN AREAS LIKE
Fraudulent billings
represented nearly 30% of the insurance industry cases. These cases were nearly twice as common as the next-most-frequently reported scheme, which was check tampering. the organizations in the insurance industry conducted fraud training for their employees and managers a higher rate than for any other industry prosecuted.
profit.
Insurance contracts provide both the insured and the
since an insurance provider might sometimes encourage it in order to obtain greater profits.
INTERNAL FRAUD
EXTERNAL FRAUD
CREATION OF A FICTIOUS COMPANY TO GENERATE INSURANCE PREMIUMS AND ISSUE FRAUDULENT POLICIES .
CON-ARTISTS, BUT THERE ARE SOME RED FLAG TO PROTECT CONSUMERS FROM BEING THE VICTIM OF LIFE INSURANCE FRAUD.
INDICATORS THAT AROUSE SUSPICION THAT A CONSUMER OR BENEFICIARY IS TRYING TO DECEIVE THE COMPANY. IF FRAUD IS PROVEN THE CLAIM WILL BE DENIED AND THE CRIME WILL BE REPORTED TO THE AUTHORITIES. FOR EXAMPLE IN CALIFORNIA INSURANCE FRAUD IS PUNISHABLE BY UP TO FIVE YEARS IMPRISON AND A $50,000 FINE.
AUTOMOBILE INSURANCE
PROPERTY INSURANCE
PROFESSOR OF HEALTH INSURANCE AT THE UNIVERSITY OF MINNESOTA, ONE OF THE MAIN REASONS THAT MEDICAL FRAUD IS SUCH A PREVALENT PRACTICE IS THAT NEARLY ALL OF THE PARTIES INVOLVED FIND IT FAVOURABLE IN SOME WAY.
ESTIMATED THAT IN 1996. 21 TO 36 PERCENT OF AUTO-INSURANCE CLAIMS CONTAINED ELEMENTS OF SUSPECTED FRAUD.
THERE IS A WIDE VARIETY OF SCHEMES USED TO
INSURANCE PROVIDERS CONSIST OF THE DESTRUCTION OF PROPERTY IN ORDER TO RECEIVE INSURANCE PAYEMENTS FOR IT.
OLDER CITIZENS
POLITE AND TRUSTING NOT REPORTING A FRAUD
FRAUD-BUSTING UNITS
EDUCATE CONSUMERS TRAIN EMPLOYEES
FORMS. INSURERS BENEFITS STATEMENT CAREFULLY ASK YOUR HEALTH CARE PROVIDER WHAT THEY CHARGE FOR A VISIT, TREATMENT. WHAT YOU WILL NEED TO PAY OUT OF YOUR POCKET. NOTE OF ALL OF YOUR HEALTH CARE AND MEDICAL APPOINTMENTS.
An insurer obtained a new corporate client. The brokerage deliberately understated the risk on the policies and as a result the insurer grossly under priced the policies. The risk the broker exposed the insurer to exceeded 100k. It was later discovered that the broker had done this with 20 large corporate clients placing the policies with numerous insurers. Investigators were alerted and investigations revealed that the incentive behind the under stating of these large corporate policies was to build a portfolio of seemingly valuable business. They then sold that business to an unsuspecting reputable broker firm. Investigations identified that the entire portfolio of business was fraudulent. False signatures were also identified on a number of policies.
The fraud created victims of 20 corporate health insurance policy holders, numerous insurers and the unsuspecting broker.
Civil legal action is pending and the matter is currently being investigated by police.