Management and reduction of fraud by analysis of the insurer’s internal and external vulnerabilities and contributions

Mihai Ovidiu Vădean ()
Additional contact information
Mihai Ovidiu Vădean: Fabrica de Asigurări, Bucharest, Romania

Journal of Financial Studies, 2021, vol. 11, issue 6, 179-187

Abstract: Fraud is a dynamic phenomenon: when the industry discovers a „scam” – a specific pattern of fraud – and sets up barriers to prevent it from recurring, another scam takes place – a new pattern is developed by fraudsters. The motivations for committing fraud vary: from opportunists who submit a fraudulent request as a way to recover their insurance premium, probably encouraged by a change in public attitudes towards crime without victims to criminal networks that use fraud as a regular source of revenue generation. The legal, organizational and commercial constraints under which the insurance industry operates often have a negative impact on existing fraud prevention, detection and investigation practices. Initially, the fight against insurance fraud focused on identifying the characteristics of fraudulent claims and fraudulent claimants – the empirical phase / traditional approach and the role that insurance company employees played in this phase was a major one. Then, given the wave of interest in the insurance industry, emphasis was placed on the use of approaches such as: a) cognitive interviewing and vocal stress analysis that were used in forensic investigation, as well; b) data extraction techniques, specially developed for fraud detection. Are just these effective? The material will try to analyze the vulnerabilities and contributions, both internal and external, that are introduced by the policies, procedures and controls implemented by the insurer within the organization.

Keywords: Fraud; claim; handler; surveyor; claim file; process; database; feedback; vulnerability (search for similar items in EconPapers)
JEL-codes: G22 (search for similar items in EconPapers)
Date: 2021
References: Add references at CitEc
Citations:

Downloads: (external link)
https://revista.isfin.ro/wp-content/uploads/2021/11/14_Vadean-Ovidiu.pdf (application/pdf)
https://revista.isfin.ro/2021/11/16/management-and ... s-and-contributions/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:fst:rfsisf:v:11:y:2021:i:6:p:179-187

Access Statistics for this article

Journal of Financial Studies is currently edited by Raluca Ladaru

More articles in Journal of Financial Studies from Institute of Financial Studies Contact information at EDIRC.
Bibliographic data for series maintained by Cosmin Catalin Olteanu ().