HomeFraud InsuranceWhat is the reason for definitively discovering "insurance fraud"?

What is the reason for definitively discovering “insurance fraud”?

It’s surprising, but do you have life insurance?

If there is an unexpected illness or injury. For example, if it is a family pillar, the family left behind at the time of death is not abandoned on the street.

Or, for those who drive cars and motorcycles. As a countermeasure in the event of an accident. You should purchase damage insurance.

I think it’s that kind of “insurance” but in the news and newspaper articles. We often see cases of insurance fraud, deliberately claiming that an accident or accident has happened in order to receive the insurance money.

Because there are sophisticated strategies employed in vehicle insurance fraud that might actually produce an accident or even injury, it can be difficult to tell the difference between a true accident and a manufactured accident. Insurance fraud, according to the insurer, “is dealt with fairly seriously.”

So how do insurance companies detect insurance fraud?

Today I would like to introduce “Insurance Fraud Fully Exposed!”

True Insurance Fraud Cases

“Fully Exposed Insurance Fraud! To show what kind of “insurance fraud” is being committed and revealed, I’d like to provide “cases” that have actually happened.

Case 1: Pretending to be injured in order to defraud a hospital insurance company of money.

A case of cheating about 2.7 million yen of insurance money by pretending to go to the hospital due to a traffic accident. This is a fraudulent billing situation.

Regarding the suspicion of the arrest. And the hospital demanded about 1.03 million yen on the day of treatment, and the couple paid around 1.68 million yen. for alimony.

Case 2: the case of defrauding insurance money by disguising it as a traffic accident

The Metropolitan Police Department uncovered a fraudulent group of 16 male executives and an unemployed man suspected of cheating for deliberately causing a traffic accident and defrauding insurance money.

The suspects deliberately caused the accident and claimed the insurance company for medical expenses, personal injury insurance, lost time compensation, etc.

As for one of the perpetrators, he worked for an insurance company for 6 years and created false documents, and committed fraud.

In the end, 16 people were caught, and the insurance money obtained through deception totaled 46 million yen.

Case 3: The case of financial fraud in fire insurance

In March 2015, four former Coast Guard officers set fire to an entertainment sign bearing the company’s name and attempted to defraud insurance money. I threw it out and set it on fire.

Moreover, he conspired with other acquaintances to defraud her of 40 million yen in fire insurance.

After the accident, one of the suspects quit his job to care for a family member. The insurance money paid for the boat was abnormally high. When I did, the crash came out.

When insurance companies receive suspicious insurance claims, as in your example, they will thoroughly investigate and eventually reveal the truth.

Insurance fraud will be detected: “a list of and a focus on unscrupulous doctors and unscrupulous hospitals” will be created.

Doctors in hospitals often cooperate to fraudulently claim insurance money by claiming to have been in an accident and hospitalized for a long period of time. Just hearing the name of the hospital makes me think, “Is this hospital suspicious?”

It may be difficult to detect a one-time scam. But it is human nature to want to commit fraud repeatedly. Because it is easy to obtain a large sum of money.

Be difficult to spot a one-time scam. Terrible human nature to desire to conduct fraud again because. It is simple to obtain a large number of money.

Insurance fraud detection: “It is very likely that the disappearance is a fraud, and the insurance company suspects”

The most common type of fraud is receiving a death benefit due to a disappearance. Except in the event of a catastrophe. If the insured disappears. The insurance company will consider it cheating and will investigate.

After 7 years of going missing. Then A judge eventually declares him “missing.”

Using this, it becomes a model in which a director of a poorly run company receives.”The Insurance money after a year. Pretending to be a missing person or an accident”.

The majority of them are collaborators of the insurance recipient. And by precisely identifying the beneficiary. The accident seems to have been located.


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