THE PROCESSES

The processes dimension allows companies to define efficient processes that support the detection and investigation of fraud in a standardized and systematic manner. Existing processes can be re-defined to optimize their impact: reducing time and costs while also releasing resources to focus on other value added tasks.

Clearly defined processes create security for your employees and enhance prospects of success for a new fraud management strategy.

Innovative technologies are now being applied to the problem of fraud detection and investigation. Selecting the right tools to support your optimized processes can allow you to pinpoint the right cases to investigate and reduce claim payments overall. In parallel, unsuspicious claims can be paid faster. By shortening the time it takes to carry out investigations the company can alleviate the pressure of a premature decision.

 Explain about the kinds of frauds in insurance sector?

 How do you detect them?

 What measures have you taken to protect them?

 What is the maximum value of loss that you have face because of frauds?

How do you make it good?

CHAPTER 16 – CONCLUSION

Insurance, a very well-known concept today and many people could relate to in more than one ways. This is the influence of the changing times that have changed the concept of insurance in the minds of the young and the old. People have changed their attitude towards their insurance and new look from being an entry of luxury to an investment and necessity. The number of people taking insurance has increased considerably in the past few decades due to the entry of private players in the market.

One knows that every coin has two sides. Similarly, insurance also has two faces. One of which is investments and getting regular returns from financial institutions for oneself and for loved ones. The other, awfully, is of which people deceive insurance companies for their undue advantage and cause intimidation to many others.

Though, there have been many laws and agencies all over the world to impede such criminal activity, it is not a full proof solution to all insurance frauds.

In a world today where every person seeks their right to information and demands the same, it is very difficult to scam them. One must know all the loop-holes of their business to scheme someone. Lack of knowledge and not knowing ones basic rights on behalf of prey could land them in scrambled scam bisque.

There have been many institutions and agencies formed all over the world t o d e t e c t fr a u d a n d p e n a l i z e t h e o n e c o n sc i e n t i o u s fo r su c h mi sh a p s. Th e r e i s d i v i si o n o f i n su r a n c e fr a u d , I N TE R N ATI O N A L A S S O C I ATI O N O F I NS U R A N C E F R A U D AGE N C I E S (I A IFA) , e t c . th r o u g h t h e e n d u r i n g a n d c o n sc i o u s e n d e a v o r o f t h e se i n st i t u t i o n s i n su r a n c e fr a u d t e mp o h a s d e c l i n e d by a n e n o r mo u s a mo u n t . Several have studied preceding and enduring market conditions to identify with the diverse frauds that take place and the reasons behind committing these frauds.

One cannot diminish frauds, schemes, swindles, scams but can positively b e a l e r t o f t h e m s o a s n o t b e a v i c t i m o f i t t h e m s e l v e s . T u m b l i n g fraudulent situations is a unremitting and collective effort of countless. One must be sensitive and offer their helping as much as they can. One can either grumble about how things are all going wide of the mark o r s w a l l o w t h e c o n s e q u e n c e s . O r p u t t h e i r f o o t d o w n a n d m a k e a n a t t e mp t t o c h a n g e t h e i mmo r a l t o t h e ri g h t . Th e w r o n g w i l l c h a n g e a n d everyone will see the bright light of truth and right with the revolution of knowledge, awareness, and an attitude for change

 INSURANCE FRAUD : THE CRIME YOU PAY FOR

Watch out- insurance crooks are picking your pocket in order to line theirs. These thieves are committing insurance fraud, one of America’s largest criminal industries. Insurance fraud is a crime, and one way or another, honest consumers and businesses pay the price.

Insurance fraud occurs every day and in every state. People of all races, incomes and ages are victimized.

 THE FUTURE- STILL DANGEROUS

Despite the encouraging progress, insurance fraud will remain a vast and dangerous criminal enterprise. Here are several fraud trends consumers should know about:

The internet will hatch new insurance swindles as computer- survey consumers buy from online insurance companies that may be virtually untraceable. Young people raised on the internet will be the vanguard of this crime wave.

The global economy is igniting huge insurance money – laundering schemes, often involving fake insurers that bilk people out of millions. Tracking them across international borders will pose a big problem.

The large population bulge og aging boomers needing more medical attention will keep health fraud near the forefront of the largest and costliest fraud crimes.

Insurance fraud against immigrants will remain a serious problem as diverse ethnic continue migrating. Many fraud crimes will be committed by fraud rings or organized mafias of immigrants themselves.

The elderly will remain one of the largest targets of insurance swindles. Investment schemes are among the newest approaches: thousands of seniors are investing in bogus verticals – life insurance policies that don’t exist or were obtained illegally.

Many seniors also are investing in fake promissory notes sold by insurance agents and guaranteed by non- existent insurance companies.

 EVERYONE’S SOLUTION

Everyone pays for a insurance fraud, and so everyone must join in stamping out these swindles. Consumers, lawmakers, insurance, companies, doctors, lawyers and many more must be part of the answer. Insurance fraud will disappear only when criminals realize fraud is a fast highway to jail, not an easy road to riches.

 PROTECT YOURSELF: STAY ALERT

You can protect yourself against insurance scams: stay alert, ask questions, and go slow or back out if an insurance transaction seems suspicious.

 Never sign blank insurance claim forms

 Demand detailed bills for repair and medical services. Check closely for accuracy.

 Make sure “free services” aren’t actually hidden in insurance bill.

 Be wary of buying insurance from door-to-door or telephone sales people.

 Be suspicious if the price of insurance seems too low to be true.

 Contact your state insurance department to make sure the agent and company are licensed.

 Keep your insurance identification number secret; insurance crooks can steal it and involve you inn scams.

 Contacts you’re STATE INSURANCE DEPARTMENT and the NATIONAL INSURANCE CRIME BUREAU if you think you’re being scammed or someone asks you it take part in a fraud.

CHAPTER 17 – REFERANCE

 Primary data had been adopted by an informal interview to agent of life insurance.

 Secondary data are adopted by collecting the information’s from

 different management books

 websites of insurance sector and especially the LIC websites

 Journals and magazines and news from newspapers.