Feds fight fraud with new fervor

Article Abstract:

Insurance fraud by insiders is a growing problem that federal law enforcement officials are focusing more resources on. The element of trust and the large amounts of cash in the insurance trade are tempting many unscrupulous insurance industry employees into underpricing schemes, asset falsification and other crimes. The nature of some fraud is complex and the legal definitions are not always clear. The federal effort to control such fraud has been aided by the Violent Crime Control and Law Enforcement Act of 1994, which criminalizes typical fraud-related behavior.

Ethical aspects, Insurance law

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Hamstrung adjusters need better ways to stop fraud

Article Abstract:

Insurers typically rely on front-line adjusters to identify possibly fraudulent claims and refer such claims to investigators. But adjusters must use marginally useful fraud-indicator checklists to identify suspicious claims. The current system can not be expected to provide insurers adequate protection from fraud. Experience-based information and mathematical models can help adjusters reliably, consistently and objectively identify moderately suspicious claims.

Management, Column, Insurance claims adjustment, Claims adjustment (Insurance)

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Industry fraud on the rise; here's how to spot it

Article Abstract:

Most insurance brokers, agents and adjusters are honest, but there is evidence that those insurance professionals are increasingly involved in fraud. Insurance companies can significantly reduce fraud by getting to know their employees better, by establishing and publicizing codes of ethics and by checking all cash-surrender situations for evidence of churning. Getting to know employees better starts with preemployment reference checks.

Safety and security measures

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