The presence of insurance in many sectors of the economy creates significant opportunities for dishonest (fraudulent) actions by clients of insurance organizations and other parties. The more criminal the environment in which insurance operates, and the less balanced the regulation of this type of insurance, the greater the opportunities for fraudulent activities.
All economic crimes in the insurance sector can be conditionally divided into so-called crimes organized as a business ("professional" fraud), which are carefully premeditated and committed by organized groups, and "opportunistic" crimes ("amateur" fraud), where clients attempt to derive illegal benefits from real insurance incidents. Fraudsters operating in groups, composed of lawyers, doctors, and sometimes even employees of the companies themselves, utilize various schemes to deceive. Meanwhile, lone fraudsters may only distort information about the reported insurance incident (exaggerating the actual damage or failing to inform the insurer of significant risks that could influence the occurrence of an insured event). According to statistics, 90% of all fraud cases are committed by lone fraudsters, while only 10% involves organized criminal groups. Russian insurers face annual losses of up to 15 billion rubles due to insurance fraud.
PILab specialists are ready to assist insurance companies in investigating insurance fraud.
Investigation of fraud cases in:
- "Personal" insurance
- Medical insurance
- Accident insurance
- Life insurance
- Property insurance for individuals and legal entities
- Carrier liability insurance
- Motor insurance.