Assumptions of the Theoretical Model of Investigation in Criminilogic Proliferation of Insurance Fraud
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Abstract
The paper presents a survey of three theoretical models of investigation into proliferation of insurance fraud, which, when reconciled among themselves, would enable one to assess the latency of such illegal acts without using criminal cases related to insurance fraud:
1) Experts’ assessment method. This method is expedient when seeking to identify evaluation of fraud latency, define recommendations for prevention of such crimes, and to penetrate tendencies of their development. The method is mostly useful for analysis of insurance fraud (or fraud in separate types of insurance) tendencies and sanctions thereby, yet less for assessment of proliferation of the phenomenon. Therefore, this method should not be applied separately from the other theoretical models presented within the article.
2) Analysis of claims handling cases. The method best suits the evaluation of fraud latency and the assessment of loss amount caused via such crimes. Yet, data received using the mentioned method should be verified by applying the experts’ assessment method.
3) Method related to statistic analysis on the basis of frequency in events occurred to insured and uninsured subject matter. The method allows deducing fraud latency evaluation by matching the cumulative statistic information from criminal cases and the number of claims raised to insurance companies.
1) Experts’ assessment method. This method is expedient when seeking to identify evaluation of fraud latency, define recommendations for prevention of such crimes, and to penetrate tendencies of their development. The method is mostly useful for analysis of insurance fraud (or fraud in separate types of insurance) tendencies and sanctions thereby, yet less for assessment of proliferation of the phenomenon. Therefore, this method should not be applied separately from the other theoretical models presented within the article.
2) Analysis of claims handling cases. The method best suits the evaluation of fraud latency and the assessment of loss amount caused via such crimes. Yet, data received using the mentioned method should be verified by applying the experts’ assessment method.
3) Method related to statistic analysis on the basis of frequency in events occurred to insured and uninsured subject matter. The method allows deducing fraud latency evaluation by matching the cumulative statistic information from criminal cases and the number of claims raised to insurance companies.
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Authors retain copyright of their work, with first publication rights granted to the Association for Learning Technology.
Please see Copyright and Licence Agreement for further details.
