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...

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 --...

We study the impact of insurance on the amount of fraud in a physician-patient relationship. In a market for credence goods, where prices are regulated by an authority, physicians act as experts. Due to their informational advantage, physicians have an incentive to cheat by inducing...

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...

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...

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...

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...

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...

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...

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...

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...

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 mounting frequency of life insurance frauds is driving up costs of insurance companies and premiums of policyholders. Investigations were carried out to assess the fraud scenario in the Indian life insurance companies, the potential risk exposure, the impact of growing events of frauds, and...

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...

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...

IT-related spillovers occur via data- and information-related transmission paths, so these types of spillovers are best studied through process-level measures. The medical claims fraud detection is a prototypical data- and information-intensive process in insurance companies. This paper examines...

We discuss the difficult question of measuring the effects of asymmetric information problems on resource allocation. Three problems are examined: moral hazard, adverse selection, and asymmetric learning. One theoretical conclusion, drawn by many authors, is that information problems may...

We discuss the difficult question of measuring the effects of asymmetric information problems on resource allocation. Three problems are examined: moral hazard, adverse selection, and asymmetric learning. One theoretical conclusion, drawn by many authors, is that information problems may...

Insurance fraud is a major source of inefficiency in insurance markets. A self-justification of fraudulent behavior is that insurers are bad payers who start nitpicking if an opportunity arises, even in circum- stances where the good-faith of policyholders is not in dispute. We relate this...

A full assessment of Israel’s compliance with the Insurance Core Principles (ICPs) of the International Association of Insurance Supervisors (IAIS) is presented. The Minister of Finance bears the political responsibility for supervisory oversight of the Israeli insurance system. Nonlife...