[PDF] Every Crime Leaves A Trace So Does Insurance Fraud eBook

Author : Laura Hymes
Publisher : John Wiley & Sons
Page : 292 pages
File Size : 28,61 MB
Release : 2014-07-22
Category : Business & Economics
ISBN : 1118700872

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Real case studies on insurance fraud written by real fraud examiners Insurance Fraud Casebook is a one-of-a-kind collection consisting of actual cases written by fraud examiners out in the field. These cases were hand selected from hundreds of submissions and together form a comprehensive picture of the many types of insurance fraud—how they are investigated, across industries and throughout the world. Entertaining and enlightening, the cases cover every type of insurance fraud, from medical fraud to counterfeiting. Each case outlines how the fraud was engineered, how it was investigated, and how perpetrators were brought to justice Written for fraud examiners, auditors, and insurance auditors Other titles by Wells: Fraud Fighter and Corporate Fraud Handbook, Third Edition Edited by Dr. Joseph T. Wells, the founder and Chairman of the Association of Certified Fraud Examiners (ACFE), the world's leading anti-fraud organization, this book reveals the dangers of insurance fraud and the measures that can be taken to prevent it from happening in the first place.

Author : Barry Zalma
Publisher :
Page : 460 pages
File Size : 26,75 MB
Release : 2019-10-31
Category :
ISBN : 9781704294742

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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.

Author : Barry Zalma
Publisher : Independently Published
Page : 408 pages
File Size : 41,35 MB
Release : 2022-03-12
Category :
ISBN :

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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.

Author : Alex Colin Campbell
Publisher : Forgotten Books
Page : 430 pages
File Size : 19,15 MB
Release : 2015-06-15
Category : Social Science
ISBN : 9781330097472

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Excerpt from Insurance and Crime: A Consideration of the Effects Upon, Society of the Abuses of Insurance, Together With Certain Historical, Instances of Such Abuses In attempting a discussion of insurance as a producer of morbid conditions in society, I enter upon a field that, so far as I know, has never been explored in its length and breadth before. While highways, inventions, finance, and many other phases of activity in modern life are dealt with by those who trace their effects, good or evil, upon society, insurance thus regarded has attracted the attention of exceedingly few writers. Yet it must be obvious to anyone who will give the matter a moment's thought that our modern world is a vastly different world from what it would have been without insurance. When we find an influence helping to mould the world in which we live, it seems well worth while to consider in what way that influence works. Nobody having, so far as my knowledge goes, preceded me in this field, I am obliged to make a first-hand study, to collect and sift such material as is within my reach, and to rely upon my own judgment for my conclusions, unguided and uuwarned by the work of others. If I am, then, as I believe, an explorer in a new field, I shall not be accused of presumption if I claim the explorer's privileges as well as undergo his labours. The explorer is not expected to do the work of the topographer, to note every small detail and give distances and directions with mathematical exactness. His report covers the general features of the territory, together with such minor facts as strike him as noteworthy. About the Publisher Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.

Author : Eric Stauffer
Publisher : Elsevier
Page : 659 pages
File Size : 30,1 MB
Release : 2006-10-11
Category : Law
ISBN : 0080477887

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Forensic Investigation of Stolen-Recovered and Other Crime-Related Vehicles provides unique and detailed insights into the investigations of one of the most common crime scenes in the world. In addition to a thorough treatment of auto theft, the book covers vehicles involved in other forms of crime—dealing extensively with the various procedures and dynamics of evidence as it might be left in any crime scene. An impressive collection of expert contributors covers a wide variety of subjects, including chapters on vehicle identification, examination of burned vehicles, vehicles recovered from under water, vehicles involved in terrorism, vehicle tracking, alarms, anti-theft systems, steering columns, and ignition locks. The book also covers such topics as victim and witness interviews, public and private auto theft investigations, detection of trace evidence and chemical traces, vehicle search techniques, analysis of automotive fluids, vehicle registration, document examination, and vehicle crime mapping. It is the ultimate reference guide for any auto theft investigator, crime scene technician, criminalist, police investigator, criminologist, or insurance adjuster. Extensively researched and exceptionally well-written by internationally-recognized experts in auto theft investigation and forensic science All the principles explained in the text are well-illustrated and demonstrated with more than 450 black and white and about 100 full-color illustrations, many directly from real cases Serves as both a valuable reference guide to the professional and an effective teaching tool for the forensic science student