Artificial intelligence (AI) is a tool that financial intermediaries and insurance companies use or are willing to use in almost all their activities. AI can have a positive impact on almost all aspects of the insurance value chain: pricing, underwriting, marketing, claims management, and...

This study examines the influence of fraud disclosure (FR_DISC) in annual reports on the financial stability of Takaful insurance (TKI) in Saudi Arabia over the period of 2014 to 2022. Moreover, the current study aims to explore the mediating impact of Shariah board size in shaping this...

Healthcare fraud is intentionally submitting false claims or producing misinterpretation of facts to obtain entitlement payments. Thus, it wastes healthcare financial resources and increases healthcare costs. Subsequently, fraud poses a substantial financial challenge. Therefore, supervised...

The US spends more than 4 trillion dollars per year on health care, largely conducted by private providers and reimbursed by insurers. A major concern in this system is overbilling, waste and fraud by providers, who face incentives to misreport on their claims in order to receive higher...

Part 1 History - Developments in risk and insurance economics: The past 50 years -- Part 2 Climate risk protection - Fifty years of US natural disaster insurance policy -- Climate risk and insurance -- Household financial resilience after severe climate events: The role of insurance -- Insuring...

The detection of anomalous data patterns is one of the most prominent machine learning use cases in industrial applications. Unfortunately very often there are no ground truth labels available and therefore it is good practice to combine different unsupervised base learners with the hope to...

Chapter 1: Introduction -- Chapter 2: Lloyd’s: its history and business practices -- Chapter 3: Lloyd’s people: their social composition and political economy -- Chapter 4: Expansion, scandals and frauds – Lloyd’s in the 1970s -- Chapter 5: The first reforms and public scrutiny --...

Audit mechanisms frequently take place in the context of repeated relationships between auditor and auditee. This paper focuses attention on the insurance fraud problem in a setting where insurers repeatedly verify claims satisfied by service providers (e.g., affiliated car repairers or members...

Ever since the advent of the economic reforms in 1991, the Indian insurance industry has been growing at a rapid rate, and is expected to reach an estimated value of 280 billion US dollars by the end of the current year. It has also experienced a paradigm shift from being a public sector...

We show a simple approach to modelling insurance frauds, both ex-ante (for the insured event), in the form of false accidents and staged events, and ex-post, in the form of inflated bills and buildups. Optimal amounts of (under)coverage and excess claims are obtained from the maximizing behavior...

This study aims to explore the current trends in fraud prevention in the insurance industry in Russia. Survey responses from 20 experts and professionals of the leading insurance companies in Moscow were collected. More than a half of them are former police officers who work at security or...

Audit mechanisms frequently take place in the context of repeated relationships between auditor and auditee. This paper focuses attention on the insurance fraud problem in a setting where insurers repeatedly verify claims satisfied by service providers (e.g., affiliated car repairers or members...

Fraud risk in insurance is a complex matter, which affects both the parties — insurers as well as policyholders. Both qualitative and quantitative research was used to understand how public attitudes about fraud are formed and what factors influence them. Among the areas explored in the survey...

Life insurance fraud is posing a big challenge for the entire industry because the number of life insurance frauds are increasing. These increasing frauds are driving up the costs and premium for the companies. In order to curtail fraudulent activities in life insurance fraud it is very much...

Insurance fraud is one of the most serious problems threatening viability of insurance companies.Insurance frauds are driving up the overall costs of insurers and premiums for policyholders. It encompasses a wide range of illicit practices and illegal acts. Insurance companies have witnessed...

This paper seeks to explain the large differences in the incidence of motor insurance fraud between Italian provinces. The econometric analysis highlights the role of the differences in per capita income and strength of social norms common to other types of crimes. Moreover the cross province...

Insurance frauds deeply affect insurance companies, policyholders, and the insurance industry as a whole. The cost of fraudulent damage affects the profitability of companies, and has negative effects on the society in terms of moral values. Increases in insurance costs can lead to increases in...

We construct panel data on house prices and the determined cause of 4.8 million individual fires in the United States between 1986 and 2010 to test whether decreases in local housing market prices coincided with increases in arson. Since some insured homeowners may attempt to disguise the actual...

An important incentive problem for the design of unemployment insurance is the fraudulent collection of unemployment benefits by workers who are gainfully employed. We show how to efficiently use a combination of tax/subsidy and monitoring to prevent such fraud. The optimal policy monitors the...

The SEC should require crowdfunding issuers under the Jumpstart Our Business Startups Act to obtain private insurance against liability based on Section 4A(c) of the Securities Act, using a model of Directors & Officers' liability insurance. Antifraud concerns could be a major reason for SEC...

This report is an analysis of the insurance core principles of Malaysia. This assessment gives a clear understanding of the regulatory and supervisory framework of the insurance sector of Malaysia. Bank Negara Malaysia (BNM) is the best insurance regulator in this region. Six percent of the...

This paper discusses findings of the Detailed Assessment of Observance on Insurance Core Principles on Singapore. The insurance industry in Singapore is growing, in particular the offshore nonlife sector. Gross premium of the sector has grown significantly by more than 80 percent in the last...

The Belgian insurance industry was adversely affected by the global financial crisis and continued to confront challenges related to legacy assets and economic uncertainties in Europe. The Belgian authorities have made significant progress in updating the insurance regulatory regime and...

El fraude de seguros es una conducta sumamente común en todos los países y México no es la excepción. Sin embargo, causa sorpresa que a pesar de su incidencia, el delito de fraude de seguros no esté regulado federalmente. El Distrito Federal en su Código Penal prevé el fraude de seguros...

Fraud in the federal crop insurance program has been currently estimated to cost taxpayers in the millions of dollars. Despite efforts by both private crop insurers and the federal government to combat fraud associated with claims in the program, crop insurance fraud, and misrepresentations...