INTRODUCTION
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Insurance Fraud is a ‘Hidden’ Crime
Few people talk about it & strongly
disapprove of arson for profit and bogus claims. Less aggressive
fraud, such as inflating a claim gets mixed reactions. To qualify as a
fraud, a claim usually must be grossly exaggerated.
Extent of Fraud
10-15% of insurance claims in Canada are
fraudulent. Insurers pay more than $1B a year in fraudulent claims.
85% of consumers pay extra premiums to cover fraudulent claims. This
does not include other possibly fraudulent transactions that cannot be
quantified. e.g., cost of improper rating because underwriting
information has been withheld. True costs can never be precisely
determined. Insurance fraud has attracted professional criminals
& opportunists.
Effects of Fraud
It is often said that insurance fraud is
acceptable because there are no victims. The "victimless" crime is the
wrong way top look at things. Fraud affects everyone, by:
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Economic loss through direct physical
damage.
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Economic loss as fire departments,
police and other public services are used.
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Indirect economic losses to enterprises
because their clients have suffered damages.
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Death or physical injury to innocent
victims, firefighters, police, etc.
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Indirect economic consequences from
higher premiums.
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Emotional and psychological effects of
fraud on victims.
RESOURCES
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Abso.com - Develops and delivers integrated, customized, Web-enabled
solutions designed to aid in the background verification, applicant
management and human resource collaboration processes. The company
serves large and small businesses with legal, factual, up-to-date,
systems and information enabling intelligent decisions and reduced
costs via automation.
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Barry Zalma - U.S. claims
and insurance fraud specialist.
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Card Cops - Credit Card Fraud.
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Financial Action Task Force on Money
Laundering
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Financial Crimes Enforcement
Network
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Fraud
Awareness and Prevention - Course C39
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Insurance Fraud Bureau - U.S. Numerous
links.
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International Compliance Association - The
International Compliance Association supports and educates
compliance professionals in the fight against terrorist financing,
corruption, money laundering and financial crime.
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Kessler
International - Offer a full
range of Forensic Accounting and Investigation Consulting services
to protect companies against the dangers of fraud, counterfeiting,
product diversion, trademark and copyright infringement, money
laundering and the recent explosion in computer crime.
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RCMP
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RECOL.ca -
Reporting Economic Crime Online (RECOL) is an initiative that
involves an integrated partnership between International, Federal
and Provincial Law Enforcement agencies, as well as, with regulators
and private commercial organizations that have a legitimate
investigative interest in receiving a copy of complaints of economic
crime.
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Transparency International - Purpose - To curb corruption by mobilising a global coalition to
promote and strengthen international and national Integrity Systems.
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