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Insurance fraud is a growing problem on a global scale. The ABI estimates that fraudulent insurance claims on motor and household policies alone cost insurers in excess of £1 billion every year. This book provides an analysis of the insurance industry’s response to the problem and examines fraud from legal and practical perspectives to determine how to manage and reduce fraud. Key issues covered include: fraud in the insurance and reinsurance context, a look at industry-wide initiatives and individual insurance companies’ approaches to the problem, consideration of recent legal developments and a look at how insurance fraud is tackled in other jurisdictions. Includes a chapter on marine insurance fraud.
Insurance fraud is a growing problem on a global scale. The ABI estimates that fraudulent insurance claims on motor and household policies alone cost insurers in excess of £1 billion every year. This book provides an analysis of the insurance industry’s response to the problem and examines fraud from legal and practical perspectives to determine how to manage and reduce fraud. Key issues covered include: fraud in the insurance and reinsurance context, a look at industry-wide initiatives and individual insurance companies’ approaches to the problem, consideration of recent legal developments and a look at how insurance fraud is tackled in other jurisdictions. Includes a chapter on marine insurance fraud.
Insurance Law – An Introduction is essential reading and will provide you with a thorough understanding of all the main areas including motor, property, financial and marine insurance. The book contains the latest case law and best practice with reference to problem areas including fraudulent claims, third party rights against insurers and construing insurance terms. Comprehensive guidance on all key areas from the duty of utmost good faith to choice of law and jurisdictional issues is given by the leading legal experts in the insurance industry.
The lack of well-documented, factual information on fraud, waste and corruption in the healthcare sector is an important ally for those who would seek to abuse healthcare systems for their own profit. Our lack of knowledge of the incidence, nature and extent of fraud, waste and corruption in healthcare is a threat to the establishment of effective counter-fraud strategies. It prevents those who finance healthcare provision from understanding in clear and quantifiable terms the need to invest resources into counter-fraud activities. As a consequence, fraud remains a matter of moral hazard and healthcare systems continue to suffer considerable financial damage, as well as all the associated consequences for the quality of care that patients receive. It was for these reasons that the 'European Healthcare Fraud and Corruption Network' (EHFCN) and the 'Dutch Healthcare Authority' (NZa, member of EHFCN) decided to collaborate to publish this book... --
According to figures published by the Association of British Insurers, the insurance industry detected 125,000 dishonest claims valued at £1.3 billion in 2016. With similar amounts of fraud going undetected each year, it is unsurprising that insurers invest around £200 million to combat it. Personal Injury Surveillance is a unique guide, providing an insight into the hitherto undisclosed methodologies of personal injury surveillance and the systemic use of an unregulated profession to investigate accident victims. Surveillance is one of many tools used by the UK insurance industry to investigate the veracity of a personal injury claim; others include statistical analysis of claims data and complex algorithms with key fraud indicators, enabling insurers to get upstream of the issue and, in some cases, actually predict fraud before it occurs. However, there is nothing more compelling than surveillance evidence which is why it remains a fundamental element of the claims management process. Significant investment in fraud awareness training coupled with new legislation and a more collaborative approach has provided the insurance industry with teeth, and it isn’t afraid to use them. This guide will provide honest claimants, their legal representatives and insurers with an enlightening, and in parts amusing, insight into the world of personal injury surveillance. It will also prove sobering for anyone contemplating the submission of a fraudulent personal injury claim with intent to defraud an insurer.
The Handbook of Asian Criminology aims to be a key reference for international scholars with an interest in the broad theme of international criminology in general, and the Asian region in particular. Contextualization is a key theme in this book. The role of context is often underemphasized in international criminology, so the Handbook of Asian Criminology’s premise that crime and the responses to it are best understood as deeply embedded in the cultural specificity of the environment which produces them will play a key role throughout the work. Attention will be given to country- and region specific attitudes towards crime and punishment.
This collection of essays, published to mark the 20th anniversary of Realistic Evaluation, celebrates the work of Professor Nick Tilley and his significant influence on the fields of policing, crime reduction and evaluation. With contributions from colleagues, co-authors and former students, many of whom are leading scholars in their own right, the thirteen essays which make up this volume contain both personal reflections and analysis of the prominent topics in Professor Tilley’s forty years of scholarship.
Countries could potentially spend significantly less on health care with no impact on health system performance, or on health outcomes. This report reviews strategies put in place by countries to limit ineffective spending and waste.
This NAO report is a follow up to one issued in the 2002-03 session (HC 393, ISBN 9780102920635), Tackling Benefit Fraud. The report sets out some key facts, including: that the total benefit expenditure is £120 billion; the total number of recipients is 18 million; the total estimated fraud is £0.8 billion. In the 2006-07 period, £154 million was spent on six strategies to reduce fraud, with a Departmental estimate of £106 million of benefit overpayments identified as a result of fraud investigation and compliance activity. Also in the 2006-07 period, the Department recovered £22 million of the total £339 million outstanding fraud debt. Although the NAO has identified that fraud has fallen from an estimated £2 billion in 2001-02 to an estimated £0.8 billion in 2006-07, official error has risen in the same period from £1 billion to £1.9 billion. Tackling fraud is a key priority for the Department for Work and Pensions, and the report examines the main anti-fraud initiatives, recognising that: tackling benefit is inherently difficult; that the UK has levels of social security fraud and error which are similar to those of comparable countries; that the Department has made good progress in tackling fraud, but will find it increasingly difficult to secure further year on year reductions. The NAO has also set out a number of recommendations, including: that the Department's management information on fraud could be improved, with greater communication between the various departmental directorates responsible for counter-fraud work; that a review of the cost effectiveness of the Customer Compliance approach (which deals with lower risk cases of fraud) should be done; that a record of the outcomes of prosecution activities should be taken by case type to provide better Departmental information; that the Department must review recovery of overpayments in fraud cases and consider setting appropriate targets for recovery from customers who have committed fraud.
A leader in decision-making research reveals how choices are designed—and why it’s so important to understand their inner workings Every time we make a choice, our minds go through an elaborate process most of us never even notice. We’re influenced by subtle aspects of the way the choice is presented that often make the difference between a good decision and a bad one. How do we overcome the common faults in our decision-making and enable better choices in any situation? The answer lies in more conscious and intentional decision design. Going well beyond the familiar concepts of nudges and defaults, The Elements of Choice offers a comprehensive, systematic guide to creating effective choice architectures, the environments in which we make decisions. The designers of decisions need to consider all the elements involved in presenting a choice: how many options to offer, how to present those options, how to account for our natural cognitive shortcuts, and much more. These levers are unappreciated and we’re often unaware of just how much they influence our reasoning every day. Eric J. Johnson is the lead researcher behind some of the most well-known and cited research on decision-making. He draws on his original studies and extensive work in business and public policy and synthesizes the latest research in the field to reveal how the structure of choices affects outcomes. We are all choice architects, for ourselves and for others. Whether you’re helping students choose the right school, helping patients pick the best health insurance plan, or deciding how to invest for your own retirement, this book provides the tools you need to guide anyone to the decision that’s right for them.