Modeling of Insurance Fraud (5)

Modeling the Disposition of Insurance Fraud

Post By: Insurance Top Stories

A variety of social systems and institutions affect the processing of a potentially fraudulent insurance claim (suspicious claim) and contribute to the ambiguities surrounding detection, evaluation and final disposition. These are shown in Figure 1.

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Figure1  Modeling  the Disposition  of Insurance  Fraud
	Modeling of  Car Insurance  Fraud as  A Graph

These include insurers’ explicit and implicit organizational rules for evaluation and final recommendation for the disposal of a claim, the political environs of the firm represented by the contemporary posture of both regulatory and judicial institutions towards the (external) treatment of consumer insurance fraud. And, finally, societal attitudes and behavior toward the issue. (Legislative impacts are certainly important, but worthy of separate review.).



To cite this document:
William C. Lesch, Bruce Byars, (2008) "Consumer insurance fraud in the US property-casualty industry", Journal of Financial Crime, Vol. 15 Issue: 4, pp.411-431, doi: 10.1108/13590790810907245