Insurance fraud is a growing problem on a global scale. The ABI estimates that fraudulent insurance claims on motor and household policies alone cost insurers in excess of £1 billion every year. This book provides an analysis of the insurance industry’s response to the problem and examines fraud from legal and practical perspectives to determine how to manage and reduce fraud. Key issues covered include: fraud in the insurance and reinsurance context, a look at industry-wide initiatives and individual insurance companies’ approaches to the problem, consideration of recent legal developments and a look at how insurance fraud is tackled in other jurisdictions. Includes a chapter on marine insurance fraud.

Insurance fraud is a growing problem on a global scale. The ABI estimates that fraudulent insurance claims on motor and household policies alone cost insurers in excess of £1 billion every year. This book provides an analysis of the insurance industry’s response to the problem and examines fraud from legal and practical perspectives to determine how to manage and reduce fraud. Key issues covered include: fraud in the insurance and reinsurance context, a look at industry-wide initiatives and individual insurance companies’ approaches to the problem, consideration of recent legal developments and a look at how insurance fraud is tackled in other jurisdictions. Includes a chapter on marine insurance fraud.

Insurance Law – An Introduction is essential reading and will provide you with a thorough understanding of all the main areas including motor, property, financial and marine insurance. The book contains the latest case law and best practice with reference to problem areas including fraudulent claims, third party rights against insurers and construing insurance terms. Comprehensive guidance on all key areas from the duty of utmost good faith to choice of law and jurisdictional issues is given by the leading legal experts in the insurance industry.

The lack of well-documented, factual information on fraud, waste and corruption in the healthcare sector is an important ally for those who would seek to abuse healthcare systems for their own profit. Our lack of knowledge of the incidence, nature and extent of fraud, waste and corruption in healthcare is a threat to the establishment of effective counter-fraud strategies. It prevents those who finance healthcare provision from understanding in clear and quantifiable terms the need to invest resources into counter-fraud activities. As a consequence, fraud remains a matter of moral hazard and healthcare systems continue to suffer considerable financial damage, as well as all the associated consequences for the quality of care that patients receive. It was for these reasons that the 'European Healthcare Fraud and Corruption Network' (EHFCN) and the 'Dutch Healthcare Authority' (NZa, member of EHFCN) decided to collaborate to publish this book... --

Countries could potentially spend significantly less on health care with no impact on health system performance, or on health outcomes. This report reviews strategies put in place by countries to limit ineffective spending and waste.

A leader in decision-making research reveals how choices are designed—and why it’s so important to understand their inner workings Every time we make a choice, our minds go through an elaborate process most of us never even notice. We’re influenced by subtle aspects of the way the choice is presented that often make the difference between a good decision and a bad one. How do we overcome the common faults in our decision-making and enable better choices in any situation? The answer lies in more conscious and intentional decision design. Going well beyond the familiar concepts of nudges and defaults, The Elements of Choice offers a comprehensive, systematic guide to creating effective choice architectures, the environments in which we make decisions. The designers of decisions need to consider all the elements involved in presenting a choice: how many options to offer, how to present those options, how to account for our natural cognitive shortcuts, and much more. These levers are unappreciated and we’re often unaware of just how much they influence our reasoning every day. Eric J. Johnson is the lead researcher behind some of the most well-known and cited research on decision-making. He draws on his original studies and extensive work in business and public policy and synthesizes the latest research in the field to reveal how the structure of choices affects outcomes. We are all choice architects, for ourselves and for others. Whether you’re helping students choose the right school, helping patients pick the best health insurance plan, or deciding how to invest for your own retirement, this book provides the tools you need to guide anyone to the decision that’s right for them.

According to figures published by the Association of British Insurers, the insurance industry detected 125,000 dishonest claims valued at £1.3 billion in 2016. With similar amounts of fraud going undetected each year, it is unsurprising that insurers invest around £200 million to combat it. Personal Injury Surveillance is a unique guide, providing an insight into the hitherto undisclosed methodologies of personal injury surveillance and the systemic use of an unregulated profession to investigate accident victims. Surveillance is one of many tools used by the UK insurance industry to investigate the veracity of a personal injury claim; others include statistical analysis of claims data and complex algorithms with key fraud indicators, enabling insurers to get upstream of the issue and, in some cases, actually predict fraud before it occurs. However, there is nothing more compelling than surveillance evidence which is why it remains a fundamental element of the claims management process. Significant investment in fraud awareness training coupled with new legislation and a more collaborative approach has provided the insurance industry with teeth, and it isn’t afraid to use them. This guide will provide honest claimants, their legal representatives and insurers with an enlightening, and in parts amusing, insight into the world of personal injury surveillance. It will also prove sobering for anyone contemplating the submission of a fraudulent personal injury claim with intent to defraud an insurer.