Pockets of Insurance Frauds in India

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Almost every month, fraudsters have been popping up in small towns across the country to carry out organised attacks on life companies. They come in all hues: faceless crooks in Punjab buying life covers with a bogus log-in on the Internet, as well as old-world racketeers armed with fake death certificates.

In the complex business of life insurance, the deal with the customer is simple: the family gets the cheque when the policyholder crosses over to the other side; indeed, to most, few things in life can be more black and white. But there can be 50 shades of grey when a death is less than honest — a truth that many private insurers are discovering every other day.

Insurance Frauds in India

According to the Indiaforensic Research, Insurance companies lose more than $ 6.25 billion to frauds. According to this research frauds are divided in two types

  1. Frauds committed by the Insurance companies and
  2. Frauds committed against the Insurance companies.

Insurers are stumbling on strange cases where the police, panchayat sachiv, lawyers and family members are hand in glove to push claims where the policyholder is still alive, where a person is made to sign a policy on her death bed, and even where a policyholder is simply a fictitious character. While for ages insurance crimes have been a fodder for movies and thriller stories, what has surprised insurance companies this time around is the organised nature of the frauds and their rising number: cases of fraud have risen to 2-4 per cent of total rejected claims from well below 1 per cent a few years ago.

At the meeting in Mumbai attended by more than 15 private life firms (including the leading players), the officials identified the hotbeds for fraudsters

The hotbeds for fraudsters are: Sabarkantha, Modasa, Kheda and Mehsana in Gujarat; Jalgaon, Dhule and Nandurbar in Maharashtra; Ganjam in Odisha, and Morena in Madhya Pradesh.

Also under watch are places like Khammam (Andhra Pradesh), Kubernagar, Sunder Nagar and Bhavnagar (in Gujarat), and parts of Punjab where, though instances of frauds have been reported, the situation is not yet alarming.

The unofficial decision among life insurers is to stay away from selling policies in these regions — particularly on the Net and covers with high sum assured, said a person who was present at the meeting. The insurers will soon present a note on the situation for the Life Insurance Council to take up the matter with the Insurance Regulatory & Development Authority.

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