Fraudulent Claims
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Warranty Fraud Management
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Author : Matti Kurvinen
language : en
Publisher: John Wiley & Sons
Release Date : 2016-06-13
Warranty Fraud Management written by Matti Kurvinen and has been published by John Wiley & Sons this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-06-13 with Computers categories.
Cut warranty costs by reducing fraud with transparent processes and balanced control Warranty Fraud Management provides a clear, practical framework for reducing fraudulent warranty claims and other excess costs in warranty and service operations. Packed with actionable guidelines and detailed information, this book lays out a system of efficient warranty management that can reduce costs without upsetting the customer relationship. You'll dig into the whole spectrum of warranty fraud, from simple sloppy procedures to systematic organized crime, and get to know the fraudulent parties, the victims, as well as the objectives and methods of the fraudulent activities in different scenarios. You'll learn how to implement controls to detect and reduce fraudulent claims and decrease the overall warranty costs. The impact of fraudulent claims is plainly spelled out alongside detailed descriptions of typical symptoms and process gaps present in diverse companies. A comprehensive, multi-modal framework for robust warranty management is presented as a template for revamping your own company's strategy. Fraudulent warranty claims occupy an estimated 3-15 percent of the average company's warranty costs, which generally average between 1-4 percent of sales. Many companies are unaware of the issue or struggle to take action against the claims for fear of upsetting business partners, or because they lack tangible evidence. This book details a robust warranty control framework that institutes transparency and control over the whole warranty chain—supporting the process far beyond just fraud reduction. Understand the different actors (customers, sales channels, service agents, warranty providers, etc.) and different forms of warranty fraud Uncover issues in your company's warranty processes Learn methods to detect and prevent fraudulent activities Implement a robust system of warranty cost control Warranty fraud is a major cost-control issue for most companies, but the sensitive nature of the topic leaves most reluctant to share their experiences and divulge their strategies. Warranty Fraud Management brings warranty fraud out into the open, and provides a clear, actionable framework for cost-savings through fraud reduction.
Insurance Fraud Volume Ii
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Author : Barry Zalma
language : en
Publisher:
Release Date : 2019-10-31
Insurance Fraud Volume Ii written by Barry Zalma and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-10-31 with categories.
Insurance Fraud Is Epidemic Insurance fraud continually takes more money each year than it did the last from the insurance buying public. There is no certain number. Most attempts at insurance fraud succeed. Estimates of the extent of insurance fraud in the United States range from $87 billion to more than $300 billion every year.Insurers and government backed pseudo-insurers can only estimate the extent they lose to fraudulent claims. Lack of sufficient investigation and prosecution of insurance criminals is endemic. Most insurance fraud criminals are not detected. Those that are detected do so because they became greedy, sloppy and unprofessional so that the attempted fraud becomes so obvious it cannot be ignored.The National Insurance Crime Bureau (NICB) estimates that almost 25% of the bodily injury claims related to auto crashes are bogus. Property and casualty claims against auto insurance are not much better, coming in at around a 10% fraud rate.A person commits the offense of insurance fraud by knowingly and with the intent to defraud any insurer presents or causes to be presented to any insurer any statement forming a part of, or in support of, a claim that contains any false, incomplete or misleading information concerning any fact or thing material to the claim. [18 Pa.C.S.A. § 4117(a)(2).] A person acts "knowingly" when he or she is aware that it is practically certain that his or her conduct will cause such a result. Likewise, a person acts "intentionally" when "it is his or her conscious object to engage in conduct of that nature or to cause such a result.As the industry attempts to keep pace with fraudsters' varied, ever-shifting tactics, it must deploy more innovative, effective anti-fraud technologies or risk dire losses. Vendors and organizations include the Coalition Against Insurance Fraud (CAIF), CSC, Detica NetReveal, Equifax, Experian, FICO, IBM, Innovation Group, Insurance Bureau of Canada (IBC), ISO/Verisk, KPMG, LexisNexis, Mattersight, Mitchell, the National Insurance Crime Bureau (NICB), SAP, SAS, and TransUnion.Insurers must also generate a close relationship with the state insurance department's fraud division or fraud bureau, local police agencies, the FBI, the ATF, the Postal Investigation Service, the local fire department's arson unit, local prosecutors, and the local U.S. Attorneys if they are to have any chance to reduce the effect of insurance fraud. Insurers should also work to make the general public, state legislators, state governors, congress members and U.S. Senators, and the Attorney General of the United States aware of the effect insurance fraud has on the public at large and the insurance industry.Wherever insurance is written insurance fraud exists. It is an equal opportunity fraud committed by people of every race, religion or national origin. Insurers who do not exercise serious anti-fraud efforts often complain that the local district attorneys and police agencies give a low priority to the crime of insurance fraud. No matter how seriously the insurers work to prove fraud the authorities often ignore them. In response, police and prosecutors complain that the insurers do nothing that police and prosecutors can use to prosecute the crime of insurance fraud while insurers complain that prosecutors ignore them when they present evidence of a fraud. There is truth in both complaints. Insurers, although compelled by statute to investigate potential insurance fraud and to present the results of their investigations to prosecutors, they are not trained as police officers. This book is written to make it clear to insurers, police and prosecutors that it is necessary to stop complaining and start working together to reduce the extent of insurance fraud. If they do not work together the crime will continue to metastasize until it will be impossible to write insurance at a profit or for a price anyone can afford.
Tackling Insurance Fraud
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Author : Lynne Skajaa
language : en
Publisher: Taylor & Francis
Release Date : 2020-11-25
Tackling Insurance Fraud written by Lynne Skajaa and has been published by Taylor & Francis this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-11-25 with Law categories.
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.
Fraudulent Claims
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Author : Matthew Chapman
language : en
Publisher: Xpl Pub
Release Date : 2007
Fraudulent Claims written by Matthew Chapman and has been published by Xpl Pub this book supported file pdf, txt, epub, kindle and other format this book has been release on 2007 with Law categories.
Whether sophisticated and complex, or simple individual acts, fraudulent claims account for the loss in millions of pounds of UK insurer's money, both in the claims themselves and in costs. Insurers are increasingly seeking to ensure fraudulent claims are eliminated, and the UK Benefits Agency, Inland Revenue, and Crown Prosecution Service all have considerable stakes in doing so too. Fraudulent Claims is a full treatment of the topic, providing litigators and insurers with a major work of reference. Contents include: -- The Tort of Deceit -- Insurance: Disclosure and Fraudulent Claims~-- Fraud as a Defense to Claims in Tort and Contract -- Evidence Burden and Standard of Proof -- Proceeds of Crime Act 2002 -- Perjury -- Damages -- Pleadings and Procedure -- Fraudulent Claims -- Exaggerated Claims -- Detecting and Proving Fraud -- Costs and Conduct -- Precedents
Fraudulent Claims
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Author : James Davey
language : en
Publisher:
Release Date : 2015
Fraudulent Claims written by James Davey and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2015 with Fraud categories.
Defending Against Insurance Fraud Claims
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Author : West Group
language : en
Publisher: Aspatore Books
Release Date : 2011
Defending Against Insurance Fraud Claims written by West Group and has been published by Aspatore Books this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011 with Law categories.
Defending Against Insurance Fraud Claims provides an authoritative, insiders perspective on best practices for aiding insurers in handling fraudulent claims. Featuring partners from some of the nations leading law firms, these experts offer strategies for establishing and implementing successful research and investigative techniques, as well as assisting insurers in preventing fraud in the future. These top lawyers provide advice for consulting experts in the field, preparing for and conducting an examination under oath, and effectively collecting and presenting key evidence. From identifying helpful resources to requesting appropriate information, these authors discuss the increasing importance of using technology and social media in the initial research process and how it can ultimately affect the outcome of a case. The different niches represented and the breadth of perspectives presented enable readers to get inside some of the great legal minds of today, as these experienced lawyers offer up their thoughts around the keys to success within this ever-evolving area of law.
Fraudulent Claims
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Author : Johanna Hjalmarsson
language : en
Publisher:
Release Date : 2014
Fraudulent Claims written by Johanna Hjalmarsson and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014 with Fraud categories.
Insurance Fraud Volume I Second Edition
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Author : Barry Zalma
language : en
Publisher: Independently Published
Release Date : 2022-03-12
Insurance Fraud Volume I Second Edition written by Barry Zalma and has been published by Independently Published this book supported file pdf, txt, epub, kindle and other format this book has been release on 2022-03-12 with categories.
INSURANCE FRAUD IS EPIDEMIC Insurance fraud continually takes more money each year than it did the last from the insurance buying public. There is no certain number. No one knows the amount that is taken by insurance fraud because most attempts at insurance fraud succeed. Estimates of the extent of insurance fraud in the United States range from $87 billion to more than $300 billion every year. The only certainty is that it is a serious crime that bleeds the insurance industry sufficiently to have states compel insurers to create special investigative units (SIU's) to investigate, deter and defeat insurance fraud to assist the state in its efforts to prosecute the crime. Insurers and government backed pseudo-insurers can only estimate the extent they lose to fraudulent claims. Lack of sufficient investigation and prosecution of insurance criminals is endemic. Most insurance fraud criminals are not detected. Those that are detected do so because they became greedy, sloppy and unprofessional so that the attempted fraud becomes so obvious it cannot be ignored. The National Insurance Crime Bureau (NICB) estimated that almost 25% of the bodily injury claims related to auto crashes are bogus. Property and casualty claims against auto insurance are not much better, coming in at around a 10% fraud rate. The National Association of Insurance Commissioners (NAIC) reports that insurance fraud occurs when an insurance company, agent, adjuster or consumer commits a deliberate deception in order to obtain an illegitimate gain. It can occur during the process of buying, using, selling, or underwriting insurance. Insurance fraud may fall into different categories from individuals committing fraud against consumers to individuals committing fraud against insurance companies. Non-medical insurance fraud is estimated at over at $40 billion dollars per year. Fraud not only inflicts extra costs on insurance companies, but it also financially impacts consumers, costing the average U.S. family between $400 and $700 per year in premiums. When insurers and governments put on a serious effort to reduce the amount of insurance fraud the number of claims presented to insurers and the pseudo-government-based or funded insurers drops logarithmically. Insurance fraud is not limited to the US. In Britain fraud costs the British economy amounts estimated in billions of British pounds. Since the amount of fraud actually detected is a small portion of what was actually found, the estimates published are little more than an educated guess. Vendors and organizations include the Coalition Against Insurance Fraud (CAIF), CSC, Detica NetReveal, Equifax, Experian, FICO, IBM, Innovation Group, Insurance Bureau of Canada (IBC), ISO/Verisk, KPMG, LexisNexis, FastCase, Mattersight, Mitchell, the National Insurance Crime Bureau (NICB), SAP, SAS, and TransUnion. No matter how seriously the insurers work to prove fraud the authorities often ignore them. In response, police and prosecutors complain that the insurers do nothing that police and prosecutors can use to prosecute the crime of insurance fraud while insurers complain that prosecutors ignore them when they present evidence of a fraud. There is truth in both complaints. Insurers, although compelled by statute to investigate potential insurance fraud and to present the results of their investigations to prosecutors, they are not trained as police officers. Insurance company employees, whether claims adjusters or SIU investigators are not trained to present evidence of a crime to a court. They can only advise professional insurance fraud investigators at the state departments of insurance or state police agencies who must then investigate further to obtain evidence that is sufficient for a charge of insurance fraud or to convince a Grand Jury to issue an indictment.
Fraudulent Claims Against Foreign Governments
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Author : United States. Congress. House. Committee on Foreign Affairs
language : en
Publisher:
Release Date : 1885
Fraudulent Claims Against Foreign Governments written by United States. Congress. House. Committee on Foreign Affairs and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1885 with Claims categories.
The Continuing Duty Of Utmost Good Faith And Fraudulent Claims
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Author : Lynne Skajaa
language : en
Publisher:
Release Date : 2005
The Continuing Duty Of Utmost Good Faith And Fraudulent Claims written by Lynne Skajaa and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2005 with Fraud categories.
