Since the birth of insurance, insurance fraud has always been an unavoidable problem. Although various insurance companies and regulatory authorities have taken various preventive measures, the losses to insurance companies and society are serious.

Faced with the changes in the increasingly diverse methods and means of insurance fraud, we can take timely measures to effectively prevent and reduce insurance.

Risks caused by fraud

Since the birth of insurance, insurance fraud has always been an unavoidable problem. Although various insurance companies and regulatory authorities have taken various preventive measures, the losses to insurance companies and society are serious.

Fraud in China's insurance market mainly comes from insurance customers, which is manifested in the form of flowers replacing trees, false reporting and fraudulent use; One accident, many frauds; Making cases and defrauding insurance money; Accident first, then buy insurance; Dishonesty, debt fraud, etc. Others are organizations or individuals other than insurance companies that illegally engage in insurance activities, or engage in fraud in the name of insurers, or collude with insurance company staff inside and outside to defraud insurance money.

Causes of insurance fraud

There are many reasons for insurance fraud, including:

1. Some policyholders or insured persons have weak legal concepts. They are not familiar with insurance laws and regulations and can't distinguish between crime and non-crime. They think that even if fraud is caught, it will only be denied compensation at most, and the awareness of law-abiding is weak. They believe that fraudulent compensation methods are secret and can be used to deceive people.

2. The spatial separation between the insurer and the insured object objectively makes insurance fraud possible. The subject matter insured by the applicant is controlled by the applicant or the insured before or after the insurance. In most cases, the insurance company can only decide whether to underwrite and what kind of rate to apply according to the policyholder's notification.

3. The whole society still lacks the credit system and perfect supervision mechanism. After many malicious fraudsters succeed, it is difficult for insurance companies to find him again. If in the credit society, once the fact of fraudulent insurance is confirmed, the parties' credit will have bad records, thus reducing the occurrence of fraud to a certain extent.

4. Poor information exchange in the insurance industry. Many insurance companies regard each other as competitors, and seldom tell each other about fraudulent insurance and compensation, which makes malicious fraudulent insurance succeed repeatedly. After being cheated, some insurance companies take a quiet way to take care of their reputation and influence, making insurance fraudsters more fearless.

5. Underwriting and compensation lack the necessary internal control mechanism. Some insurance companies adopt extensive management and hold the attitude of "everything in the basket", so it is impossible to make a scientific risk assessment of the subject matter of insurance before underwriting. When claims occur, the first site survey rate is not high, and the ability to distinguish true from false is not strong.

6, the strong temptation of high returns. Insurance contract can make the insured pay a small amount of premium and get hundreds of times of insurance protection. Low cost and high income provide a source of power for insurance fraud to a certain extent, prompting them to expect the success of fraud and get rich overnight.

Countermeasures of insurance fraud

In the face of the increasingly diversified changes in the ways and means of insurance fraud, we should start from the following aspects to effectively prevent and reduce the risks brought by insurance fraud.

1. Strengthen legal publicity and win public support. It is necessary to strengthen anti-fraud propaganda through newspapers, magazines, radio and television, change people's wrong understanding of insurance fraud, explain the harm of insurance fraud to the public, and let people understand that insurance fraud is a crime, and its victims are not only insurance companies, but also honest policyholders. We should take measures to encourage reporting and exposure of insurance fraud incidents around us, and strive for the support of all sectors of society for anti-insurance fraud through various channels. At the same time, it is necessary to remind the insured in time to verify the authenticity of the identity of insurance institutions and business personnel when purchasing insurance, and to confirm the authenticity and integrity of insurance policies and insurance contracts.

2. Strengthen internal management and effectively control risks. We should make full use of modern technology to build an information platform, establish a remote loss management system, improve the scientificity of underwriting and compensation, and put an end to artificial compensation. Scientific risk assessment of the subject matter insured before underwriting, so as to nip fraud in the bud; Strengthen compensation, insist on double-person survey to determine losses, improve the first-site survey rate, and take the last step of insurance fraud prevention. It is necessary to establish a post rotation system to prevent internal and external collusion from defrauding reparations. It is necessary to strengthen special anti-fraud training for underwriting and compensation personnel, and learn from the experience of foreign anti-insurance fraud, and set up a full-time anti-insurance fraud department within the company. It is necessary to withdraw reserves in full and collect warehousing premiums in time to prevent interception and misappropriation.

3. Strengthen internal and external contacts and smooth information channels. All insurance companies should carry out anti-fraud cooperation on the premise of not revealing business secrets. Insurance industry associations should become the link of information exchange between insurance companies, collect insurance companies' fraudulent claims and suspicious claims materials as soon as possible for necessary processing, and establish an industry-wide insurance fraud database so that insurance companies can enjoy information. In the insurance stage, it can be used to identify whether the applicant has insurance fraud or not and whether he has signed fraudulent insurance contracts with multiple insurers; In the claim stage, it can be used to identify repeated claims of the same property insurance accident and so on. At the same time, it is necessary to strengthen contacts with insurance companies in other countries, exchange experiences with each other, and prevent transnational insurance fraud.

4. Entrust a professional organization to conduct claim investigation. When an insurance company encounters an insurance fraud case, it should generally report it to the public security organ for assistance. The public security organs are faced with various fields of society, and there are many cases, some of which are difficult to deal with in time. The staff of commercial investigation institutions and information consulting companies have rich experience in social affairs and case investigation. Through the business help and support of these institutions, we can make up for this deficiency to some extent. Some investigation agencies, such as Stiehl, have been recognized by many internationally renowned investigation associations and can provide fast and accurate services in overseas accident investigation.

Further reading: How to buy insurance, which is good, and teach you how to avoid these "pits" of insurance.