How the Insurance frauds research was conducted


Pradeep Akkunoor – Research scholar based in Thailand is one of the pioneers in the Insurance frauds.

Insurance fraud is typically characterized as the external or third party fraud. Unlike other frauds where the employees commit the frauds by virtue of their occupation, Insurance companies face the risk of frauds from the external and third party frauds. It becomes difficult to understand the psychology of the external fraudsters.

Additionally there are no patterns in the transactions as their could be some red-flags in the credit card usage. Hence Insurance frauds are highly complicated to investigate. This is domain which requires attention of other industries.

Research on Insurance frauds
Fraud is a phenomenon that affects every industry, however, given the nature of the insurance business, the fraud risk is even more pronounced in this sector. A philosopher had once said, you do not know what you can not measure or quantify. In this context, it is Indiaforensic’s humble effort to quantify the magnitude of the fraud that affects this industry and take on the problem head on by identifying appropriate solutions. I would take this opportunity to thank all the Insurance companies and the managers who took part in this survey which enabled us to come up with this research report. The consensus is eye-opening – the insurance industry is losing close to 15000 Crores rupees every year! That is almost 9% of revenues of an insurance company. This clearly indicates the seriousness of the problem. With the publication of this report, we hope to achieve greater awareness among consumers which can eventually lead to reduction of insurance frauds.

Pradeep launched the research to understand the perceptions of the

1. Claims managers [80% of the respondents were claims managers]
2. Employees working other divisions in the Insurance Industry [ 20% of respondents were from various other divisions ]

These findings are very interesting and the research is available for download on request.
Methodology followed by Indiaforensic in the research is as follows

* Decided on the research concept
* Study of issues
* Preparation of questionnaires
* Collecting responses through personal interviews and email surveys
* Data Analysis of the survey responses
* Report Creation
* Expert Review and Comments
* Publishing and Awareness Drive

This is a very interesting research and needs to be followed by those who are in the Special Investigation Units of the various insurance companies.

Quantification of losses
One of the most significant achievements of this research is quantification of the absolute approximate losses in Indian Rupees to the Insurance Industry in the year 2009. The figure is bound to change but this report will act as the benchmark.