Insurance Fraud

Dent Repair on 02-3-2010

Insurance the fraud in the sector of the insurances

Defrauds was always considered a discussed exit, are too fast insurance companies to deny complaints where they suspectent fraudulent activities could exist? The responsibility is on insurance companies to show that the fraudulent activities exist, knowing that a complaint is fraudulent is a thing but proof of this in front of the court on A the "équilibre of the probabilities" is a whole different history.

For the criminal continuation the insurer must prove that the fraudulent activities took place without any reasonable doubt. There are 3 principal types of fraudulent declarations of disaster:

1. Declarations of disaster Manufactured: –

* the manufacture of the loss Implies or loss causes which makes it possible to the individual to place a complaint when a could’ ve avoided.

* The policy-holder does not suffer any loss or a non covered loss by the insurer

* For for example the owner of a vehicle parks his car already damaged in the way one to give the attack to thus the branches and hail damages the car, it then complaints in order to take the repaired car.

* The Ombudsman of insurance will not tolerate complaints of this type because the fraudulent activities are intentional, material and prejudicial with the insurance company.

2. A valid loss due to the fraud of insurance: –

* the less serious case of the fraud of insurance, here the policy-holders suffers a true loss that the insurance company cover, the policy-holders does not claim only it is not authorized too.

* The policy-holder however provides information distort to prevent the insurance company from taking a technical point or to delay the complaint.

* For example a complaint for damage within the framework of a personal policy of insurance-accidents where there is no damage of conflict is covered, but doctor does not sign to accompany the report/ratio thus secured forging mill the signature of doctors on the complaint.

* The Ombudsman of insurance would require of the insurer to admit this complaint because the insurance company was not compromised nor the action does not have any material relation with complaint.

3. Exaggerated declarations of disaster: –

* the assure claims more insurance company than it is authorized with.

* It is the most common type of the fraudulent declaration of disaster and most difficult to prove.

* An example is when the house of a policy-holder is burgled after which it claims for various additional articles which were lost before burgling took place or which it ever had initially.

* An exaggerated complaint is considered fraudulent according to jurisprudence when: – ensured envisages clearly to defraud insurers. – where the exaggeration of the declaration of disaster is so excessive it carries out to the inference which the policy-holders cannot honestly have made with the complaint.