总结：保险欺诈类型
保险欺诈发生在有人向保险公司提供虚假信息以获得不应得到的利益时。波兰法律系统将欺诈定义为一种白领犯罪，并可能导致严厉的惩罚。
保险欺诈是一种严重的犯罪行为，对欺诈者来说可能会产生严重后果。这不是一种无受害者的犯罪。欺诈性索赔会推高保险费用，从而导致所有诚实的客户支付更高的保费。
保险行业认识到了这一问题，并准备采取行动打击此类欺诈活动。其方法包括：利用技术和数据分析，合作执法机构和专门的警察部门。
保险欺诈可能包括
- 伪造或制造的汽车事故（“碰撞换现金”）；
- 伪造滑倒和跌倒事故；
- 虚假声称食品或饮料中有异物；
- 伪造死亡以领取赔偿；
- 虚假提交死亡赔偿申请。
Among crimes against business transactions, the Polish Criminal Code provides for extortion of compensation, or so-called insurance fraud. Insurance fraud can be committed either by an entity acting to obtain undue compensation, or by one who caused an insured event to occur under a contract for the benefit of another entity. In other words, anyone can commit insurance fraud if they acted for financial gain.
Examples of insurance fraud include:
- posing as traffic collisions in order to extort compensation;
- posing as car thefts;
- setting up or taking over business entities to defraud vehicle insurance claims;
- inflating repair costs by using false documents;
- antedating insurance policies;
- overstating the value of insured objects;
- collecting compensation from several insurance companies for the same loss.
Detecting insurance fraud
According to estimates by the Polish Chamber of Insurance, between 30 and 40% of all claims paid out are extortions. These figures illustrate the scale of the problem, which is growing, as the number of insurance frauds is forecast to increase further. Most often, this applies to vehicle compensation under AC and civil liability insurance. Given the prevalence of such practices, it is very important to have adequate compliance regulations.
Among insurance crimes, the predominant offenses are those described in Articles 286 § 1 and 3 of the Polish Criminal Code. This is the causing of an unfavorable disposition of property of another entity by misleading it or taking advantage of such a mistake. The number of classic insurance frauds described in Article 298 of the Polish Criminal Code is also very high. Slightly less frequent are computer insurance frauds and crimes described in the Insurance and Reinsurance Business Act.
KKZ Law Firm provides:
- full compliance legal support;
- advice in responding to crisis situations, including the development of a strategy of action and a possible line of defense;
- representation before law enforcement agencies for entities harmed by fraud by drafting a crime notification, participation in procedural activities and contacts with judicial authorities at every stage of preparatory and judicial proceedings;
- handling internal channels of whistleblower notifications;
- conducting internal compliance audits, internal investigations, preparing reports with detected irregularities and recommendations for changes;
- conducting internal training for employees, executives and board members on compliance related to insurance fraud.
We address our offer to:
- board members, supervisory board members and executives of commercial companies;
- persons conducting business activities;
- insurance companies;
- whistleblowers;
- entities harmed by insurance crimes.
Summary: Types of insurance fraud
Insurance fraud happens when someone provides false information to an insurance
company in order to gain something of value that he or she would not have received otherwise. The Polish legal system defines fraud as a crime which is white-collar crime and can carry heavy penalties.
Insurance fraud is a serious crime which can result in serious consequences for fraudsters. It is not a victimless crime. Fraudulent claims influence prices of insurance we all pay by driving up costs, so as a result all honest customers pay higher insurance premiums.
The insurance industry is aware of the problem and ready to fight against this sort of fraudulent activities. Its methods include: using technology and data analytics; cooperating with law enforcement agencies and specialist police units.
Insurance fraud may include:
- staged or caused auto accidents (crash for cash);
- staged slip and fall accidents;
- false claim of foreign object in food or drink;
- faking a death to collect benefits,
- falsely filing a phony death claim.
Protect Your Business from Insurance Fraud with Expert Support
Take the first step toward protecting your business. Contact us today for a consultation and let our experienced team help you strengthen your company’s defenses against insurance fraud. Safeguard your assets, reputation, and future success—because your business deserves nothing less.
