Fighting insurance fraud together – ThePrint – ANIPressReleases

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One of the main reasons for this paradox is the widespread insurance fraud, which costs the Indian insurance industry millions of rupees every year. Fraudulent claims cause claims ratios to rise, resulting in higher premium costs and a trust deficit. Such deceptive practices hinder the growth of the industry and negatively impact society.

At the heart of every insurance contract is the principle of “utmost good faith”, requiring all parties to act honestly and disclose relevant information. Fast claims processing and efficient payments help claimants recover from financial setbacks without delay, improving public perception and motivating more people to consider insurance.

However, fraud undermines this trust and hinders insurers’ ability to efficiently handle genuine claims. Based on past experiences with fraud, insurance companies have developed systems to detect and mitigate fraudulent activity. Nevertheless, fraud consumes valuable operational resources such as labor and financial reserves.

Some common forms of insurance fraud that affect good relationships include:

* Staged Accidents: Fraudsters deliberately cause accidents to make false claims for vehicle damage and personal injury. For example, some organize a fire accident in their factory when sales decrease. They aim to recover losses and profit from insurance claims by staging such an accident.

*Phantom Billing: A fraudulent practice in which health care providers inflate or charge for services that were never provided to the patient. This is often used to exploit insurance benefits, resulting in inequitable financial benefits for the provider while driving up costs for insurers and patients.

* Fake Policies: Perpetrators pose as authentic insurance entities to sell counterfeit policies and collect premiums for non-existent or invalid policies. abusing the trust of individuals looking for real coverage. Because these policies are fraudulent, they have no legal validity, leaving victims with no actual coverage and often unaware until they attempt to file a claim.

* Non-existent damage: Insured persons exaggerate claim amounts by deliberately damaging or misrepresenting the condition of insured property in order to receive a higher payout.

To avoid becoming a victim of fraud, the customer must follow these protocols:

* Check the authenticity of the policy: ask for the insurance intermediary’s valid license and confirm his/her authorization. Visit the official website and contact the company to verify the authenticity of the policy.

* Check the channel: purchasing policy from reliable sources. If you are buying online, verify the insurer’s official website domain as fraudsters often create fake websites to deceive customers. Verify the insurer’s official website domain and use secure ‘https’ websites.

* Use Empaneled Services: Avail services of empaneled hospitals and motorcycle garages for quality care and discounted rates.

* Choose secure payment methods: Pay the insurer directly via check, debit/credit card or online to create a clear transaction trail.

While vigilant customers can prevent many cases of fraud, insurers also use forensics, data analysis and advanced technology to detect and prevent fraudulent activity. In collaboration with the government, regulators and institutions such as Insurance Information Bureau (IIB), VAHAN, UIDAI, RTO, CCTNS, judicial records and the Medical Council, the industry is actively working to address this issue to improve fraud detection, identification of risks and improve prevention. . This integration allows insurers to receive claims reports early, leading to faster settlements and fewer lawsuits.

By staying informed and being careful, customers can protect themselves from fraud. Together with the industry’s efforts, we can create a safer and more reliable insurance environment. Bajaj Allianz General Insurance is committed to fighting fraud and ensuring real customers get the protection and benefits they deserve. We strive to build a robust and transparent insurance ecosystem through continuous innovation and collaboration with stakeholders.

As we celebrate International Fraud Awareness Week 2024, let’s pledge to remain vigilant and work together to combat fraud to ensure a safer and more reliable insurance landscape for all.

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