The motives for fraud are clear, it’s a financial crime. People can not pay the bills. They figure stealing from an insurance company which is big and greedy is no great moral wrong and no one will miss the money. However, even if the company is big and greedy it is still wrong. How people get caught by an insurance company Fraud units at insurance companies are experts. But the reason people get caught are for obvious reason. People make stupid mistakes. However, as a word of warning, I worked in the insurance industry for years, they have very good trick for finding fraud. They are very clever. So please do not consider it.
If you want something to think about think about the Auto insurance fraud penalties. www. political-economy. com A finding of arson is not necessarily an indicator of insurance fraud as a motive. There are plenty of reasons why a third party may set fire to a business or private residence. Those reasons may include revenge, jealousy/competition, concealing another crime within, or even mental illness or anarchist behavior of the arsonist. Like all crime, motive is an important consideration and oftentimes the evidence at the crime scene will shed light on motive. It’s usually pretty easy to distinguish an accidental fire from an arson.
So once the fire is determined to be arson then investigators begin to look for evidence of motive. Obviously, in order to consider insurance fraud the owner has to have insurance (or believe they have insurance). If investigators believe that insurance fraud is the motive they will check the policy to determine the value, beneficiary, and the date of purchase or last update. Most importantly they want to see if the date of purchase or last update corresponds with any stressor in the owners life (loss of job, failed relationship, significant anniversary, bankruptcy, etc.).
That may shed light on the “trigger” leading to the decision to commit arson www. forensics4fiction. com Insurance fraud occurs when any act committed with the intent to fraudulently obtain some benefit or advantage to which they are not otherwise entitled or someone knowingly denies some benefit that is due and to which someone is entitled. Insurance fraud has existed ever since the beginning of insurance as a commercial enterprise. [1] Fraudulent claims account for a significant portion of all claims received by insurers, and cost billions of dollars annually.
Types of insurance fraud are very diverse, and occur in all areas of insurance. Insurance crimes also range in severity, from slightly exaggerating claims to deliberately causing accidents or damage. Fraudulent activities also affect the lives of innocent people, both directly through accidental or purposeful injury or damage, and indirectly as these crimes cause insurance premiums to be higher. Insurance fraud poses a very significant problem, and governments and other organizations are making efforts to deter such activities. Read more: http://www. answers. com/topic/insurance-fraud#ixzz1trN25UJz Causes.
The “chief motive in all insurance crimes is financial profit. ”[1] Insurance contracts provide both the insured and the insurer with opportunities for exploitation. According to the Coalition Against Insurance Fraud, the causes vary, but are usually centered on greed and holes in the fraud fight. [2] Often, those who commit insurance fraud view it as a low-risk, lucrative enterprise. Drug dealers who have entered insurance fraud [3] think it’s safer and more profitable than working street corners. Compared to other crimes, court sentences for insurance fraud can be lenient, so scammers may try to take advantage of the system.
Though insurers try to fight fraud, some will pay suspicious claims thinking it is cheaper legal action. Another reason that this opportunity arises is in the case of over-insurance, when the amount insured is greater than the actual value of the property insured. [1] This condition can be very difficult to avoid, especially since an insurance provider might sometimes encourage it in order to obtain greater profits. [1] This allows fraudsters to make profits by destroying their property because the payment they receive from their insurers is of greater value than the property they destroy.
Insurance companies are also susceptible to fraud because false insurance claims can be made to appear like ordinary claims. This allows fraudsters to file claims for damages that never occurred, and so obtain payment with little or no initial cost. The most common form of insurance fraud is inflating of loss. Losses due to insurance fraud It is virtually impossible to determine an exact value for the amount of money stolen through insurance fraud. Insurance fraud is designed to be undetectable, unlike visible crimes such as robbery or murder.
As such, the number of cases of insurance fraud that are detected is much lower than the number of acts that are actually committed. [1] The best that can be done is to provide an estimate for the losses that insurers suffer due to insurance fraud. The Coalition Against Insurance Fraud estimates that in 2006 a total of about $80 billion was lost in the United States due to insurance fraud. [4] According to estimates by the Insurance Information Institute, insurance fraud accounts for about 10 percent of the property/casualty insurance industry’s incurred losses and loss adjustment expenses.
[5] The National Health Care Anti-Fraud Association estimates that 3% of the health care industry’s expenditures in the United States are due to fraudulent activities, amounting to a cost of about $51 billion. [6] Other estimates attribute as much as 10% of the total healthcare spending in the United States to fraud—about $115 billion annually. [7] In the United Kingdom, the Insurance Fraud Bureau estimates that the loss due to insurance fraud in the United Kingdom is about ? 1. 5 billion ($3. 08 billion), causing a 5% increase in insurance premiums.
[8] The Insurance Bureau of Canada estimates that personal injury fraud in Canada costs about C$500 million annually. [9] Hard vs. soft fraud Insurance fraud can be classified as either hard fraud or soft fraud. [10] Hard fraud occurs when someone deliberately plans or invents a loss, such as a collision, auto theft, or fire that is covered by their insurance policy in order to receive payment for damages. Criminal rings are sometimes involved in hard fraud schemes that can steal millions of dollars.
[11] Soft fraud, which is far more common than hard fraud, is sometimes also referred to as opportunistic fraud. [10] This type of fraud consists of policyholders exaggerating otherwise legitimate claims. For example, when involved in a collision an insured person might claim more damage than was really done to his or her car. Soft fraud can also occur when, while obtaining a new insurance policy, an individual misreports previous or existing conditions in order to obtain a lower premium on their insurance policy. [10] Read more: http://www. answers. com/topic/insurance-fraud#ixzz1trNQCLHr.