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On the life insurance fraud and its prevention

Author: LiXiaoMing
Tutor: WeiShengQiong；PengShaoBing
School: Southwestern University of Finance and Economics
Course: Finance
Keywords: Life Insurance Fraud
CLC: F842.4
Type: Master's thesis
Year: 2000
Downloads: 584
Quote: 1
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Abstract

Insurance fraud origins can be traced back the insurance industry being founded, was almost in a sense life gambling, speculators dedicated to those who do not have insurance benefits for their people, such as royals, celebrities and even criminals term life insurance insurance, early death of the insured attempt to seek huge insurance. Allegedly, at the time there have been some short-term insured died, the beneficiary to obtain insurance tragedy. State of affairs has led to the spread of malignant British Parliament on the insurance industry intervention, the United Kingdom in 1774 of the \The bill emphasized that came into force in an insurance policy, the insured on the subject of life as an insurance or event should have a conflict of interest. In the ensuing two hundred years, it is indeed a number of insurance fraud cases occurred, although the vast majority of life insurance penetration into, but it is still at a controllable level. However, in the past ten years, the situation has changed dramatically. Commercial insurance fraud losses caused to the life insurance company life insurance premium income has reached 10% -20% of fraud has been developed to the extent rampant. So far, the Chinese life insurance for a certain degree of fraud, there is no practical measures, China Life Insurance fraud is not about statistics, it's rare for insurance fraud and its prevention aspects concerning the exchange of information. Of course, in the past two or three years, China has realized the importance of anti-insurance fraud, the fraud on the agenda, and to proceed to claims personnel be trained, has identified some of the fraudulent cases, and in the news media medium to be reported. Chinese insurers increasingly recognized the need to conduct a comprehensive insurance fraud, system solution, because the existence of fraud affecting the profitability of insurance companies, and more importantly, fraud lead honest policyholders must get insurance protect additional premium paid. In October 1995 China promulgated the \The idea of ??people fraudulent insurance company nipped in the bud. \for reference. This article describes the life insurance fraud situations, causes and hazards; through a large number of case studies of its manifestations and the corresponding identification clues, signs; summarized in the full experience of Western countries on the basis of fraud, proposed the establishment of China Life Insurance Fraud mechanisms and measures ideas. The wording of the specific structure of this paper are described below. Insurance Fraud Chapter Overview This chapter contains three major issues: the concept and characteristics of insurance fraud, insurance fraud, insurance fraud, the status and feasibility analysis of hazards and fraud. Insurance fraud can macroeconomics, microeconomics and jurisprudence three angles are defined. From a macroeconomic point of view of the field of life insurance fraud is the underground economy; view from the field of microeconomics, insurance fraud in the market economy system produced a special kind of \Life insurance fraud, comply with the general behavior of the three elements of fraud. On this basis, the life insurance fraud has both subjective and objective characteristics. Subjectively, the insured, the insured and the beneficiary has intentionally defrauding insurance purposes; objectively, in a variety of fraudulent violation of complex object, namely public and private property ownership, and our insurance system. Worldwide perspective on life insurance fraud is a very worrying situation. In the European insurance market, according to statistics, some life insurance companies offer insurance due to fraud resulting from benefit payments of up to 50% of premium income, while in China, since the 1990s several years, China's PICC premium income in the year the company 40 million yuan of the municipal branch, every year a variety of insurance fraud and unreasonable expenditure of 300 million to 4 million yuan, accounting for about 10% of premium income, while the corresponding preventive measures but almost none. Relative to ten years ago, and now we have enough anti-fraud work conditions. Including the people, adequate legal and technical support, as well as a certain degree of experience, we can work to reduce fraud seriously endangering the life insurance industry. Chapter manifestations of life insurance fraud liability and life insurance changes to adapt the manifestation of life insurance fraud is divided into mortality patterns and non-death mode. Life insurance fraud mortality patterns include the following four categories: first, deliberately murdered the insured; Second, malicious use of the insured person; Third, the insured committed suicide; fourth, the insured or the insured person violated this obligation, in order to achieve the purpose of defrauding insurance. lt; WP = 4 gt; non-death model includes the following three types: (1) the use of a third party body, the insured person is falsely corpses; (2) the insured person fabricated serious accident occurs, see corpses; ( 3) using the credentials of the insurance fraud. Each of these has a corresponding cheat mode feature which distinguishes it from other, which for our fraud identification and determination provides important signs and clues. Based on these characteristics summarize the anti-fraud methods became sciences. The third chapter analyzes the causes of life insurance fraud, insurance fraud Why would? By external environmental changes brought about major social ethical standards and norms change significantly, life insurance fraud is the profound social roots. In addition, the insurance industry's own life factors also led to the proliferation of the underlying causes of fraud. These include: insurance products demand side - the reasons for the insured clients, but also from the supply side of the insurance product - the reason insurance companies, as well as the insurance business intermediaries - insurance agents and insurance brokers reasons. A general insurance customers, due to their lack of proper understanding of insurance, in some predisposing factors under the implementation of insurance fraud is likely to retaliate insured or windfall. At this time, if the social and legal punishment of fraud is not enough, even the loopholes, while life insurance companies paid insufficient attention to the long-term for fraud, claims low quality of personnel, unscientific claims process, along with insurance intermediaries irregularities, fraud, it is easy to succeed. Visible, insurance fraud today?

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