Fraud is one of the most common activities against insurance companies, and those who participate in this crime seek to appropriate benefits or compensation that clearly do not correspond to them.
Currently, these types of actions continue to occur and the sanctions are not really taken into account so that they do not continue to occur.
There are many cases of attempted fraud caused by the insured, where they have exaggerated and wanted to show that the accident has caused them more damage than they have actually suffered, such as taking advantage of a small blow to the car to receive compensation that allows them to fix a part or paint any part of the vehicle.
However, fraud does not always occur on the part of the insured, since insurance industry workers take advantage of their condition within the sector to obtain benefits and justify a claim from a known customer.
There is also the proven case that other companies have been involved in fraudulent activities against the insurer, such as clinics, mechanical workshops, among others, where they falsify invoices and reports.
Now we will share with you the most frequent types of fraud within the insurance sector to understand their nature:
1.Hiding information: many times it is sought to hide that an event has occurred due to the negligence of the insured or that the damages have been greater because the affected party did not comply with the security measures.
2. Giving erroneous information: complementing the previous case, in some frauds an attempt is made to distort the information of the incident that occurred, changing the moment in which it occurred, the location, cause and even people involved.
3. Simulation of an accident that does not happen: within this type we can get a false theft or an appliance that “has been damaged” but in reality if it works.3. Simulation of an accident that does not happen: within this type we can get a false theft or an appliance that “has been damaged” but in reality if it works.
4. Exaggerating the consequences of the claim: within this point we find claims related to health, since there are cases where the insured try to exaggerate their ailments and illnesses that they do not actually have.
5. Intentionally causing a claim: deliberately producing a claim is one of the most used techniques to try to defraud the insurer.
The prevention of fraud is an issue that directly affects the operation of claims, thus impacting the result of operations, that is why through LISA Claims insurance companies will be able to filter suspicious behavior through a fraud funnel and also have an early warning.
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