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Insurance Fraud - Wikipedia Insurance frauds

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Insurance fraud is any do something dedicated to defraud an cover process. This occurs when a claimant attempts to gain some good or advantage they are not entitled to, or when an insurer knowingly denies some good that is due. According to the United States Federal Bureau about Investigation, the most common schemes include: fee diversion, fee churning, asset diversion, including workers compensation fraud. Perpetrators inside these schemes can exist cover business employees or claimants.[1]False cover claims are insurance claims filed accompanied by the fraudulent intention towards an cover provider.

Insurance fraud has existed since the beginning about cover when a commercial enterprise.[2] Fraudulent claims report for a significant portion about all claims received via insurers, including worth billions about dollars annually. Types about cover fraud are diverse, including occur inside all areas about insurance. Insurance crimes too range inside severity, from slightly exaggerating claims to deliberately causing accidents or damage. Fraudulent activities affect the lives about innocent people, both directly via accidental or intentional cut or damage, including indirectly when these crimes lead to higher cover premiums. Insurance fraud poses a significant problem, including governments including other organizations seek to inhibit such activity.

An epigram via the Roman poet Martial provides a clear evidence the phenomenon about cover fraud was already well-known inside the Roman Empire during the First Century AD:[3]

"Tongilianus, you paid two hundred for your house;
An smash also common inside this city destroyed it.
You collected ten times more. Doesn't it seem, I pray,
That you set flames to your personal house, Tongilianus?"

Book III, No. 52

Causes[edit]

The "chief motive inside all cover crimes is financial profit".[2] Insurance contracts give both the insured including the insurer accompanied by opportunities for exploitation.

Insurance fraud - Wikipedia

According to the Coalition Against Insurance Fraud, the causes vary, yet are usually centered on greed, including on holes inside the protections on fraud.[4] Often, those who commit cover fraud view it when a low-risk, lucrative enterprise. For example, drug dealers who own entered cover fraud [5] think it's safer including extra profitable than working street corners. Compared to those for other crimes, court sentences for cover fraud can exist lenient, reducing the danger about extended punishment. Though insurers campaign against fraud, some compensate suspicious claims anyway, when settling such claims is often cheaper than judiciary action.

Another basis for fraud is over-insurance, inside which someone insures possessions for extra than its actual value.[2] This condition can exist hard to avoid, especially since an cover provider might occasionally encourage it to gain greater profits.[2] This lets fraudsters profit via destroying their property, as they accept an cover payout greater that the use about the property. The most common forms about cover fraud are re-framing a non-insured destruction to make it an event covered via insurance, including inflating the use about the loss.[6]

Insurance companies are too susceptible to fraud as it's possible for fraudsters to file claims for damages that never occurred.

Losses expected to cover fraud[edit]

It is tough to place an exact use on the money stolen via cover fraud. Insurance fraud is deliberately undetectable, unlike noticeable crimes such when robbery or murder. As such, the number about cases about cover fraud that are detected is a lot lower than the number about acts that are really committed.[2] The best that can exist agreed is to give an estimate for the losses that insurers hurt expected to cover fraud. The Coalition Against Insurance Fraud estimates that inside 2006 a total about on $80 billion was lost inside the United States expected to cover fraud.[7] According to estimates via the Insurance Information Institute, cover fraud accounts for on 10 percent about the property/casualty cover industry's incurred losses including loss adjustment expenses.[8] The National Health Care Anti-Fraud Association estimates that 3% about the condition be concerned industry's expenditures inside the United States are expected to fraudulent activities, amounting to a worth about on $51 billion.[9] Other estimates attribute when a lot when 10% about the total healthcare spending inside the United States to fraud—about $115 billion annually.[10] Another study about all types about fraud dedicated inside the United States cover institutions (property-and-casualty, business liability, healthcare, communal security, etc.)put the true worth at 33% to 38% about the total change flow via the system. This study resulted inside the book heading "The Trillion Dollar Insurance Crook" via J.E. Smith. In the United Kingdom, the Insurance Fraud Bureau estimates that the loss expected to cover fraud inside the United Kingdom is on £1.5 billion ($3.08 billion), causing a 5% increase inside cover premiums.[11] The Insurance Bureau about Canada estimates that special cut fraud inside Canada costs on C$500 million annually.[12] Indiaforensic Center about Studies estimates that Insurance frauds inside India costs on $6.25 billion annually.[13]

Hard vs. velvety fraud[edit]

Insurance fraud can exist classified when either tough fraud or velvety fraud.[14]

Hard fraud occurs when someone deliberately plans or invents a loss, such when a collision, machine theft, or flames that is covered via their cover policy [15]so they can insist advance for damages. Criminal rings are occasionally complex inside tough fraud schemes that can steal millions about dollars.[16]

Soft fraud, which is far extra common than tough fraud, is occasionally too referred to when opportunistic fraud.[14] This type about fraud consists about policyholders exaggerating otherwise-legitimate claims. For example, when complex inside an automotive impact an insured individual might insist extra destruction than really occurred. Soft fraud can too occur when, while obtaining a modern condition insurance policy, an individual misreports earlier or existing conditions to gain a lower fee on the cover policy.[14]

Insurance fraud - Wikipedia

Types about cover fraud[edit]

Life insurance[edit]

Life cover fraud may involve faking death to insist being insurance. Fraudsters may occasionally turn up a few years at the end of disappearing, claiming a loss about memory.[17]

An instance about being cover fraud is the John Darwin disappearance case, which was an investigation into the do something about pseudocide dedicated via the British one-time teacher including prison officer John Darwin, who turned up alive inside December 2007, five years at the end of he was thought to own died inside a canoeing accident. Darwin was reported when "missing" at the end of failing to inform of to work following a canoeing trip on March 21, 2002. He reappeared on December 1, 2007, claiming to own no memory about the past five years.

Another instance is one-time British Government minister John Stonehouse who went missing inside 1974 from a beach inside Miami. He was discovered living beneath an assumed name inside Australia, extradited to Britain including jailed for seven years for fraud, theft including forgery.

Health be concerned insurance[edit]

Health cover fraud is described when an intentional do something about deceiving, concealing, or misrepresenting details that results inside condition be concerned benefits being paid to an individual or group.

Fraud can exist dedicated either via an insured individual or via a provider. Member fraud consists about claims on behalf about ineligible members and/or dependents, alterations on enrollment forms, concealing pre-existing conditions, failure to inform of other coverage, prescription drug fraud, including failure to tell claims that were a result about a work-related injury.

Provider fraud consists about claims submitted via bogus physicians, billing for services not rendered, billing for higher level about services, diagnosis or treatments that are outside the room about practice, alterations on claims submissions, including providing services while medical licenses are either suspended or revoked. Independent medical examinations debunk false cover claims including allow the cover business or claimant to seek a non-partial medical view for injury-related cases.

According to the Coalition Against Insurance Fraud, condition cover fraud depletes taxpayer-funded programs like Medicare, including may victimize patients inside the hands about certain doctors.[18] Some scams involve double-billing via doctors who charge insurers for treatments that never occurred, including surgeons who perform unnecessary surgery.[19]

According to Roger Feldman, Blue Cross Professor about Health Insurance at the University about Minnesota, only about the main reasons that medical fraud is such a prevalent practice is that nearly all about the parties complex find it favorable inside some way. Many physicians perceive it when needed to give quality be concerned for their patients. Many patients, although disapproving about the idea about fraud, are occasionally extra willing to accept it when it affects their personal medical care. Program administrators are often lenient on the issue about cover fraud, when they want to maximize the services about their providers.[20]

The most common perpetrators about healthcare cover fraud are health be concerned providers. One reason for this, according to David Hyman, a Professor at the University about Maryland School about Law, is that the historically-prevailing attitude inside the medical profession is only about "fidelity to patients".[21] This incentive can lead to fraudulent practices such when billing insurers for treatments that are not covered via the patient's cover policy. To do this, physicians rate for a different service that the policy covers, rather than the service they rendered.[22]

Another motivation for cover fraud is a desire for financial gain. Public healthcare programs such when Medicare including Medicaid are especially conducive to fraudulent activities, when they are often run on a fee-for-service structure.[23] Physicians utilize several fraudulent techniques to achieve this end. These can include "up-coding" or "upgrading", which involve billing for extra expensive treatments than those really provided; providing, including later billing for, treatments that are not medically necessary; scheduling extra visits for patients; referring patients to other physicians when no further treatment is really necessary; "phantom billing", billing for services not rendered; including "ganging", billing for services to family members or other individuals who are accompanying the patient yet who did not personally accept any services.[23]

Perhaps the greatest total dollar amount about fraud is dedicated via the condition cover companies themselves. There are numerous studies including articles detailing examples about cover companies intentionally not paying claims including deleting them from their systems,[24] denying including cancelling coverage, including the obvious underpayment to hospitals including physicians beneath what are normal fees for be concerned they provide.[25] Although hard to gain the information, this fraud via cover companies can exist estimated via comparing revenues from fee payments including expenditures on condition claims.

In response to the increased amount about condition be concerned fraud inside the United States, Congress, via the Health Insurance Portability including Accountability Act about 1996 (HIPAA), has specifically established condition be concerned fraud when a combined criminal offense accompanied by punishment about up to ten years about prison inside addition to significant financial penalties.

Automobile insurance[edit]

Fraud rings or groups may copy movement deaths or leg collisions to make false cover or exaggerated claims including collect cover money. The circle may involve cover claims adjusters including other people who create phony police reports to process claims.[26]

The Insurance Fraud Bureau inside the UK estimated there were extra than 20,000 staged collisions including false cover claims across the UK from 1999 to 2006. One tactic fraudsters utilize is to drive to a busy junction or roundabout including brake sharply causing a motorist to drive into the back about them. They insist the other motorist was at fault as they were driving also fast or also close behind them, including make a false including inflated insist to the motorist's insurer for whiplash including damage, which can compensate the fraudsters up to £30,000.[27] In the Insurance Fraud Bureau's initial year or operation, the usage about data mining initiatives exposed cover fraud networks including led to 74 arrests including a five-to-one return on investment.[28]

The Insurance Research Council estimated that inside 1996, 21 to 36 percent about auto-insurance claims contained elements about suspected fraud.[29] There is a spacious variety about schemes used to cheat machine cover providers. These ploys can differ greatly inside complexity including severity. Richard A. Derrig, vice president about study for the Insurance Fraud Bureau about Massachusetts, lists several ways that auto-insurance fraud can occur,[30] such as:

Staged collisions[edit]

In staged impact fraud, fraudsters utilize a machine vehicle to leg an smash in the business of the innocent party. Typically, the fraudsters' vehicle carries four or five passengers. Its driver makes an unexpected manoeuvre, forcing an innocent association to collide in the business of the fraudster's vehicle. Each about the fraudsters then files claims for injuries continuous inside the vehicle. A "recruited" doctor diagnoses whiplash or other soft-tissue injuries that are tough to dispute later.

Other examples include jumping inside start about cars when agreed inside Russia. The driving conditions including roads are dangerous accompanied by numerous people trying to swindle drivers via jumping inside start about expensive-looking cars or crashing into them. Hit including runs are very common including cover companies infamously specialize inside denying claims. Two-way cover coverage is very expensive including almost completely unavailable for vehicles over ten years old–the drivers can sole gain basic liability. Because Russian courts do not like using verbal claims, most people own dashboard cameras installed to warn would-be perpetrators or give evidence for/against claims.[31]

Exaggerated claims[edit]

A actual smash may occur, yet the deceitful owner may take the opportunity to incorporate a whole range about earlier minor destruction to the vehicle into the garage rate associated in the business of the actual accident. Personal injuries may too exist exaggerated, particularly whiplash.[32] Insurance fraud cases about exaggerated claims can too include claiming destruction to the motor that is not from the smash reported inside the claim.[33]

Examples[edit]

Examples about soft auto-insurance fraud include filing extra than only insist for a single injury, filing claims for injuries not related to an automobile accident, misreporting payment losses expected to injuries, including reporting higher costs for car repairs than those that were really paid. Hard auto-insurance fraud can include activities such when staging machine collisions, filing claims when the claimant was not really complex inside the accident, submitting claims for medical treatments that were not received, or inventing injuries.[34]Hard fraud can too occur when claimants falsely inform of their vehicle when stolen. Soft fraud accounts for the more about fraudulent auto-insurance claims.[29]

Another instance is that a individual may illegally register their motor to a location that would net them cheaper cover rates than where they really live, occasionally called rate evasion. For example, some drivers inside Brooklyn own Pennsylvania license plates, as cover rates for a motor registered to an address inside rural Pennsylvania are a lot less than they are inside Brooklyn. Another type about automobile cover fraud, well-known when "fronting", involves registering someone other than the actual primary driver about a motor when the primary driver about the car. For example, parents might list themselves when the primary driver about their children's vehicles to avoid young driver premiums.

"Crash for cash" scams may involve random unaware strangers, set to be clear when the perpetrators about the orchestrated crashes.[35] Such techniques are the classic rear-end shunt (the driver inside start suddenly slams on the brakes, possibly in the business of brake lights disabled), the decoy rear-end shunt (when following only car, another only pulls inside start about it, causing it to brake sharply, then the initial motor drives off) or the helpful wave shunt (the driver is waved into a line about queuing movement via the scammer who promptly crashes, then denies waving).[36]

Organized crime rings can too exist complex inside auto-insurance fraud, occasionally carrying out schemes that are very complex. An instance about only such ploy is particular via Ken Dornstein, author about Accidentally, on Purpose: The Making about a Personal Injury Underworld inside America. In this scheme, well-known when a "swoop-and-squat", only or extra drivers inside "swoop" cars compulsion an unsuspecting driver into position behind a "squat" car. This crouch down car, which is usually filled in the business of several passengers, then slows abruptly, forcing the driver about the chosen motor to collide with the crouch down car. The passengers inside the crouch down motor then file a insist with the other driver's cover company. This insist often includes bills for medical treatments that were not needed or not received.[37]

An scene that took place on Golden State Freeway June 17, 1992, brought public attention to the existence about organized job rings that leg machine accidents for cover fraud. These schemes generally consist about three different levels. At the top, there are the professionals—doctors or lawyers who diagnose false injuries and/or file fraudulent claims including these earn the bulk about the profits from the fraud. Next are the "capper (insurance fraud)s" or "runners", the middlemen who gain the cars to crash, farm out the claims to the professionals at the top, including recruit participants. These participants at the bottom-rung about the scheme are desperate people (poor immigrants or others inside want about quick cash) who are paid around $1000 USD to place their bodies inside the paths about cars including trucks, playing a kind about Russian roulette with their lives including those about unsuspecting motorists around them. According to investigators, cappers usually hire inside their personal ethnic groups. What makes busting these staged-accident job rings hard is how quickly they move into jurisdictions with lesser enforcement, at the end of a crackdown inside a particular region. As a result, inside the US several levels about police including the insurance industry own cooperated inside forming task forces including sharing databases to track insist histories.[38][39]

In the United Kingdom, there is an increasing prevalence about false whiplash claims to car insurance companies from motorists complex inside minor car accidents (for instance; a shunt). Because the mechanism about cut is not fully understood, A&E doctors own to rely on a patient's external symptoms (which are easy to fake). Resultingly, "no win no fee" personal injury solicitors exploit this "loophole" for easy compensation money (often a £2500 payout). Ultimately this has resulted inside increased motor insurance premiums, which has had the knock-on effect about pricing younger drivers off the road.

Property insurance[edit]

Possible motivations for this can include obtaining advance that is worth extra than the use about the possessions destroyed, or to destroy including later accept advance for goods that could not otherwise exist sold. According to Alfred Manes, the more about possessions cover crimes involve arson.[40] One reason for this is that any evidence that a flames was started via arson is often destroyed via the flames itself. According to the United States Fire Administration, inside the United States there were about 31,000 fires caused via arson inside 2006, resulting inside losses about $755 million.[41]

Council compensation claims[edit]

The fraud involving claims from the councils' insurers suppose staging damages blamable on the local authorities (mostly falls including trips on committee owned land) or inflating the use about existing damages.[42]

Detecting cover fraud[edit]

The diagnosis about cover fraud generally occurs inside two steps. The initial step is to identify suspicious claims that own a higher possibility about being fraudulent. This can exist agreed via computerized statistical reasoning or via referrals from claims adjusters or cover agents. Additionally, the public can give tips to cover companies, code administration including other organizations regarding suspected, observed, or admitted cover fraud perpetrated via other individuals. Regardless about the source, the next step is to refer these claims to investigators for further analysis.

Due to the sheer number about claims submitted each day, it would exist far also expensive for cover companies to own employees check each insist for symptoms about fraud.[43] Instead, numerous companies utilize computers including statistical reasoning to identify suspicious claims for further investigation.[44] There are two main types about statistical reasoning tools used: supervised including unsupervised.[43] In both cases, suspicious claims are identified via comparing facts on the insist to wanted values. The main difference between the two methods is how the wanted values are derived.[43]

In a supervised method, wanted values are obtained via analyzing records about both fraudulent including non-fraudulent claims.[43] According to Richard J. Bolton including David B. Hand, both about Imperial College inside London, this method has some drawbacks when it requires absolute certainty that those claims analyzed are really either fraudulent or non-fraudulent, including as it can sole exist used to find types about fraud that own been dedicated including identified before.[43]

Unsupervised methods about statistical detection, on the other hand, involve detecting claims that are abnormal.[43] Both claims adjusters including computers can too exist trained to identify "red flags", or symptoms that inside the past own often been associated with fraudulent claims.[45] Statistical diagnosis does not prove that claims are fraudulent; it merely identifies suspicious claims that must exist investigated further.[43]

Fraudulent claims can exist only about two types:[46]

  • they can exist otherwise legitimate claims that are exaggerated or "built up", or
  • they can exist false claims inside which the damages claimed never really occurred.

Once a built up insist is identified, cover companies usually seek to negotiate the insist down to the appropriate amount.[47] Suspicious claims can too exist submitted to "special investigative units", or SIUs, for further investigation. These units generally consist about knowledgeable claims adjusters with exceptional training inside investigating fraudulent claims.[48] These investigators look for certain symptoms associated accompanied by fraudulent claims, or otherwise look for evidence about falsification about some kind. This evidence can then exist used to deny advance about the claims or to prosecute fraudsters if the violation is bad enough.[49]

When an cover company's fraud department investigates a fraud claim, they frequently proceed inside two stages: pre-contact including post-contact.[50] In the pre-contact leg they analyze all accessible evidence ahead of they contact the suspect. They may reviewing submitted paperwork, reach out to third parties, including assemble evidence from accessible sources. Then, inside the "post-contact" stage, they examination the suspect to assemble extra details and, ideally, gain an incriminating statement. Insurance fraud investigators are trained to question the suspect inside a way that precludes the suspect raising a valid defense at a after time. For example, questions on access to insist forms preclude the defense that another individual filled out the fraudulent documents. Common defenses that the suspect examination may preclude include, for example, that the suspect lacked knowledge that their declaration was false,[51] lacked the intention to defraud,[52] or made an ambiguous declaration that was after misinterpreted.[53] Full disclosure may add believability to a suspect's report about events, yet omissions from disclosure or false statements may detract from the suspect's believability inside after interviews or proceedings.[53]

In the context about condition insurance, fraud via condition cover companies is occasionally found via comparing revenues from premiums paid on the expenditure via the condition cover companies on claims. For example, inside 2006 the Harris County Medical Society, inside Texas, had a condition cover rate increase about 22 percent for "consumer-driven" condition plan from Blue Cross including Blue Shield about Texas. This was despite the fact that during the earlier year Blue Cross had paid out sole 9 percent about the collected fee dollars for claims.[25]

Legislation[edit]

National including local governments, especially inside the last half about the twentieth century, own recognized cover fraud when a bad crime, including own made efforts to punish including avoid this practice. Some major developments are listed below:

United States[edit]

  • Insurance Fraud is specifically classified when a job inside all states, though a minority about states sole criminalize certain types (e.g. Oregon sole outlaws Worker Compensation including Property Claim fraud).[14]
  • The Coalition Against Insurance Fraud was founded inside 1993 to help campaign against cover fraud. This organization collects details on cover fraud, including is the sole anti-fraud alliance expressive for consumers, cover companies, administration agencies including others. Through its unique work, the Coalition empowers consumers to campaign against back, helps fraud fighters better find this job including deters extra people from committing fraud. The Coalition supports this mission in the business of a large including continually expanding armory about efficient tools: Information, study & data, services including insight when a principal voice about the anti-fraud community.
  • Approximately only third about these investigations result inside criminal conviction, only third result inside denial about the claim, including only third result inside advance about the claim.[48]
  • 19 states require mandatory insurer fraud plans. This requires companies to type programs to combat fraud including inside some cases to develop investigation units to find fraud.[14]
  • 41 states own fraud bureaus. These are code administration agencies where "investigators review fraud reports including begin the prosecution process."[14]
  • Section 1347 about Title 18 about the United States Code states that whoever attempts or carries out a "scheme or artifice" to "defraud a condition be concerned good program" will exist "fined beneath this heading or imprisoned not extra than 10 years, or both." If this scheme results inside bodily injury, the violator may exist imprisoned up to 20 years, including if the scheme results inside dying the violator may exist imprisoned for life.[54]

Besides production laws extra severe, Legislation has too come up accompanied by a list for management that should exist implemented so that companies are better suited to combat the possibility about being scammed. That list includes:

  • Understanding that fraud does be present including that there is a high possibility for it happening.
  • Being fully informed about the dangers including severity about the problem.
  • Understanding the importance about the hiring process including how important it is to hire honest individuals.
  • Learn to agreement in the business of the economic side about business. That means putting procedures including policies inside place to catch including agreement in the business of individuals trying to commit fraud.[55]

Canada[edit]

  • The Insurance Crime Prevention Bureau was founded inside 1973 to help campaign against cover fraud. This organization collects details on cover fraud, including too carries out investigations. Approximately only third about these investigations result inside criminal conviction, only third result inside denial about the claim, including only third result inside advance about the claim.[56]
  • British Columbia's Traffic Safety Statutes Amendment Act about 1997 states that any individual who submits a machine vehicle cover insist that contains false or misleading details may on the initial offence exist fined C$25,000, imprisoned for two years, or both. On the second offense, that individual may exist fined C$50,000, imprisoned for two years, or both.[57]

United Kingdom[edit]

  • A major portion about the Financial Services Act 1986 was intended to help avoid fraud.[58]
  • The Serious Fraud Office, set up beneath the Criminal Justice Act 1987, was established to "improve the investigation including prosecution about bad including complex fraud."[58]
  • The Fraud Act 2006 specifically defines fraud when a crime. This do something defines fraud when being dedicated when a individual "makes a false representation", "fails to tell to another individual details which he is beneath a judiciary duty to disclose", or abuses a position inside which a individual is "expected to safeguard, or not to do something against, the financial interests about another person". This do something too defines the penalties for fraud when custody up to ten years, a fine, or both.[59]
  • A task force that specializes inside tracking criminals who knowingly commit fraud.[60]

See also[edit]

References[edit]

  1. ^ "FBI — Insurance Fraud". Fbi.gov. September 8, 2005. Retrieved February 7, 2014.
  2. ^ a b c d e Manes, Alfred. "Insurance Crimes." p. 34.
  3. ^ Jo-Ann Shelton, As the Romans Did: A Sourcebook inside Roman Social History (New York: Oxford University Press, 1988), 65.
  4. ^ "Why Fraud Persists". Coalition Against Insurance Fraud. Insurancefraud.org. April 4, 2012.
  5. ^ Kendall, Marisa. Southwest Florida gangs eschew street for Internet, [1] The News Press - Fort Myers, Fla. January 17, 2012
  6. ^ "Soft Fraud including Possibilities for Prevention | Gen Re". Gen Re Perspective. Retrieved December 11, 2017.
  7. ^ Coalition Against Insurance Fraud. Annual Report.
  8. ^ Insurance Information Institute. "Insurance Fraud."
  9. ^ National Health Care Anti-Fraud Association. "The Problem about Health Care Fraud."
  10. ^ Hyman, David A. "Health Care Fraud including Abuse." p. 532.
  11. ^ Insurance Fraud Bureau. "Fighting Organized Insurance Fraud." p. 2.
  12. ^ Insurance Bureau about Canada. "Cost about Personal Injury Fraud."
  13. ^ "Indiaforensic Study on quantification about fraud losses to Indian Insurance Sector "
  14. ^ a b c d e f Insurance Information Institute. "Fraud."
  15. ^ Viaene, Stijn; Dedene, Guido (April 2005). "Insurance Fraud: Issues including Challenges". The Geneva Papers on Risk including Insurance. 29 (2): 316. doi:10.1111/j.1468-0440.2004.00290.x.
  16. ^ Coalition Against Insurance Fraud. "Learn About Fraud."
  17. ^ Summers, Chris (November 17, 2004). "Couple face 'fake drowning' trial". BBC. Retrieved November 17, 2004.
  18. ^ Quiggle, James. [2] "Health Fraud" Scam Alerts. Coalition Against Insurance Fraud, 2011
  19. ^ U.S. Attorney's Office (July 26, 2011). "Salisbury Cardiologist Convicted about Implanting Unnecessary Cardiac Stents". FBI.
  20. ^ Feldman, Roger. "Economic Explanation." p. 569-570.
  21. ^ Hyman, David A. "Health Care Fraud including Abuse." p. 541.
  22. ^ Hyman, David A. "Health Care Fraud including Abuse." p. 547.
  23. ^ a b Pontell, Henry N., et al. "Policing Physicians." p. 118.
  24. ^ Fried, Joseph P. (August 2, 2000). "Metro Business; New York State Fines Insurer $500,000". The New York Times.
  25. ^ a b "hcfan.3cdn.net" (PDF). Retrieved February 3, 2012.
  26. ^ "San Diego Fraud Ring Cracked". Insurance Journal. December 20, 2002. Retrieved April 24, 2006.
  27. ^ Howard, Bob (December 16, 2006). "Fraud body warns about collision scams". BBC. Retrieved December 2, 2007.
  28. ^ Grant, Ian (August 9, 2007). "Insurance Fraud Bureau's data-mining initiatives net fraudsters". Computer Weekly. Retrieved December 2, 2007.
  29. ^ a b Tennyson, Sharon et al. "Claims Auditing" p. 289.
  30. ^ "Insurance Fraud" (PDF). Retrieved August 8, 2013.
  31. ^ Galperina, Marina (June 13, 2012). "Why Russians Are Obsessed With Dash-Cams". Jalopnik. Retrieved November 19, 2012.
  32. ^ Press Association (December 11, 2012). "Government plans to cut whiplash cut claims | Money | guardian.co.uk". Guardian. Retrieved June 8, 2013.
  33. ^ "Types about cover fraud". City about London Police. March 2, 2016. Retrieved July 18, 2017.
  34. ^ Derrig, Richard A. "Insurance Fraud." p. 274.
  35. ^ "BBC News - Car collision scams at record level". Bbc.co.uk. August 21, 2010. Retrieved August 21, 2010.
  36. ^ The One Show Team - September 15, 2008 3:50 PM (September 15, 2008). "Crash for change - a swindle for the unquestioning? - Consumer". Bbc.co.uk. Retrieved August 21, 2010.
  37. ^ Dornstein, Ken. Accidentally on Purpose. p. 3.
  38. ^ "motherjones.com". motherjones.com. June 17, 1992. Retrieved February 3, 2012.
  39. ^ Robertson, Grant; Perkins, Tara (December 27, 2010). "How small-time machine cover scams own evolved into big business inside Canada". The Globe including Mail. Toronto.
  40. ^ Manes, Alfred. "Insurance Crimes." p. 35.
  41. ^ U.S. Fire Administration. "Arson Fire Statistics."
  42. ^ "Housing including Council Tax Benefit fraud - Allerdale Borough Council". Allerdale.gov.uk. November 2, 2009. Retrieved August 21, 2010.
  43. ^ a b c d e f g Bolton, Richard J. "Statistical Fraud Detection." p. 236.
  44. ^ Derrig, Richard A. "Insurance Fraud." p. 277.
  45. ^ Viaene, Stijn, et al. "Insurance Claim Fraud Detection." p. 375.
  46. ^ Lincoln, Robyn; Wells, Helene; Petherick, Wayne (July 1, 2003). "An Exploration about Automobile Insurance Fraud". Bond University. Centre for Applied Psychology & Criminology. Retrieved October 20, 2018.
  47. ^ Derrig, Richard A. "Insurance Fraud." p. 278.
  48. ^ Viaene, Stijn, et al. "Insurance Claim Fraud Detection." p. 374.
  49. ^ Ghezzi, Susan Guarino. " Private Network."
  50. ^ Ball, Lindon (January 31, 2006). "How the diagnosis about cover fraud succeeds including fails". Psychology, Crime including Law. 12 (2): 163–180.
  51. ^ Keeton, Page (1958). "Fraud: The Necessity for an Intent to Deceive". UCLA Law Review (4). Retrieved December 7, 2017.
  52. ^ Podgor, Ellen S. (1999). "Criminal Fraud". American University Law Review. 48 (4). Retrieved December 7, 2017.
  53. ^ a b Parker, Jessica; Smith, Andrew (January 4, 2017). "Representing Individuals inside Interviews: The UK Perspective". Global Investigations Review. Law Business Research. Retrieved August 1, 2017.
  54. ^ Office about the Law Revision Counsel, U.S. House about Representatives. "United States Code."
  55. ^ Silverstone, Howard; Davia, Horward R. (April 13, 2005). Fraud 101: Techniques including Strategies for Detection. Hoboken, New Jersey: John Wiley & Son, Inc. p. 6. ISBN 978-0471721123.
  56. ^ Clarke, Michael. "The Control about Insurance Fraud." p. 10.
  57. ^ Legislative Assembly about British Columbia. "Traffic Safety Statutes Amendment Act."
  58. ^ a b Staple, George. "Serious including Complex Fraud." p. 127.
  59. ^ Ministry about Justice. "Fraud Act 2006."
  60. ^ "Insurance Fraud Taskforce". Gov.UK. Retrieved March 13, 2019.

External links[edit]


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