What is Insurance Fraud? Definition, Types and Solutions - Become an Insurance Fraud Investigator

100

Top Questions on Insurance Fraud


Q1. How fraud cases are tried in a Court in India?


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Q2. Does all illegal acts are fraud?


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Q3. What can be done to prevent or reduce insurance fraud?


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Q4. Give an example of fraud trigger for a claim of burglary:


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Q5. Given an example of insurance fraud trigger in a Fire claim


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Q6. What is Manufacturing Defects fraud?


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Q7. What is Phantom Ship?


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Q8. Which types of incidences are included in Bankers Blanket Insurance fraud?


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Q9. A unique hazard that have presence in a Group Life Policy is_____


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Q10. What is Bloodstock Insurance Fraud?


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Q11. What is Fake Hospitalization fraud?


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Q12. What is Civil Liability?


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Q13. Which warranty may be imposed in the policy to prevent fraud in live-stock fraud?


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Q14. Who is bearing the cost of fraud prevelent in Insurance Sector?


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Q15. If an insurer wish to take legal recourse against an insured, for making a false claim, what the insurer need to proof?


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Q16. When an insured misrepresent some material facts, with intent to defraud an insurer, how the insurer can prove that a fraud has been committed against it?


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Q17. Identify under which legislation, an insurer can initiate legal case againgst an insurance fraudstar.


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Q18. How fraud cased are communicated or information exchanged between peer insurers in the insurance industry?


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Q19. Does death by suicide is covered in India under Life Insurance cover?


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Q20. To whom insurers require to disclose the adequacy of systems put in place for detecting and preventing fraud and other irregularities, on an annual basis?


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Q21. What data/information relating to various fradulent cases required to be filed with IRDA?


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Q22. What is called Internal Fraud?


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Q23. What is the Mission Statement of IRDA on Insurance Fraud?


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Q24. What is the first step in monitoring insurance frauds?


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Q25. Give some examples of notable fraud triggers:


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Q26. What is Arson?


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Q27. What is one of the crual step that a fraud investigator takes, in case of a possible fire fraud?


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Q28. What kind of fraud, is generally committed during the period when the shipping sector faces economic downturn or when the shippping industry is in recession?


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Q29. What is Rust Bucket Fraud?


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Q30. What kind of fraud usually committed by some Ship owner when the vessel reaches the end of its economic life?


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Q31. Who is Ethical Hacket and what he usually do?


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Q32. To smuggle illegal goods, what type of maritime fraud is / are resorted to?


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Q33. What is "Scuttling"?


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Q34. What is "Phantom Cargo Theft"?


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Q35. What type of frauds are usually committed by Clearing and Forwarding Agents?


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Q36. Some examples of Agency commission frauds:


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Q37. Example of an Insurance Fraud, that can be committed by the Management of an insurance company:


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Q38. What is "Fraud Triggers"?


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Q39. What is estimated figure of Insurance Fraud committed annually in India?


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Q40. What is "Phantom medical bill"?


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Q41. What induce a person to commit Insurance Fraud?


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Q42. What is the defination of fraud given in any legislation in India?


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Q43. Identify a simple, cost effective step, that every insurer can take, to reduce adverse selection (and fraud) drastically, at the time of inception of a policy itself.


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Q44. In which type of insurance, Fraud is higher in India?


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Q45. Which Policy-making body, works to generate the necessary political will to bring about national legislative and regulatory reforms in its member countries worldwide?


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Q46. Given an example of insurance fraud that can be done in a Fidelity Insurance Policy?


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Q47. What precautions need to be taken by an Insurance Fraud Investigator to carryout the investigation?


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Q48. Which is /are not usual example of Corporate Fraud?


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Q49. What are the major elements of fraud?


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Q50. What is Policy Fronting?


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Q51. What is the big challenge in fighting fraud in insurance sector?


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Q52. Who issued Insurance Fraud Monitoring Framework in India?


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Q53. As an employee in an Insurance Company, what actions would be taken first in a fraud response?


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Q54. One of the thing that should not be done when a fraud is detected in an Insurance company:


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Q55. What kind of fraud can be anticipated in case of Liability Claim?


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Q56. What is the standard of proof required to be established in case of an Criminal Offence?


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Q57. What is "Upgrading" in Health Insurance means?


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Q58. What is "Ganging" in Health Insurance means?


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Q59. In case a fraud is detected, what are the steps that can be initiated by the insurance company?


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Q60. If the Life-Assured had been missing, what is the additional document required to be submitted for settlement of claim?


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Q61. What are those factors, the analysis of which can indicate possible fraud?


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Q62. What motivates insured to exaggerate their claims?


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Q63. What are criminal rings?


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Q64. What is Doctor shopping?


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Q65. Who is in a position to detect the presence of any fraud indicator(s) in a claim?


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Q66. Fraudulent non-disclosure is also known as:


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Q67. What are the circumstances need to be established, by an Insurance company, to repudiate an Insurance Contract, even after the expiry of 3 years?


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Q68. Which agency act as a focal point in the fight against all types of maritime crimes, malpractices and combating maritime frauds?


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Q69. Risk of Piracy is higher in?


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Q70. Name the Committee formed following a series of high-profile corporate frauds and accounting scandals?


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Q71. For how long an insurer is required to retain records of its all customer's identification documents?


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Q72. What is layering in money laundering?


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Q73. Suspicious transaction are to be reported to the Director, FIU-IND within how may days?


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Q74. Which regulations is aimed at providing stronger surveillance powers against funding of terrorism, and combating money laundering?


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Q75. What document(s) can be accepted by an Insurance company, as a proof of Customer Identification?


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Q76. How NGO transactions are monitored?


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Q77. Which one is India's national agencies that handles financial intelligence?


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Q78. Which is the most commonly used money laundering technique, used in international trade?


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Q79. Who are classfied as the high-risk profile group in Insurance, as per AML guidelines?


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Q80. What are the categories of insurance products/business lines that are not considered as vulnerable to AML transactions?


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Q81. Does a Rich person comes under the category of High Risk Profile?


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Q82. Can Discounted ULIP can be revived?


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Q83. When is the Proposer is generally required to provide Age-Proof?


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Q84. What are usual Policy conditions in a Insurance Policy


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Q85. Is there a chance of getting the insurance claim in case of policy for which premium payment has been stopped?


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Q86. If a proposal received from a person with terminal cancer, what will usually be response of an underwriter


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Q87. Which one is cheapest form of Life Insurance?


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Q88. Does Subrogation principle applies in Life Insurance?


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Q89. When a Policy lapses, who gets benefited?


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Q90. What is special Revival Scheme (SRV)?


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Q91. Which policies, usually does Not have loan facility?


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Q92. What is Bancassurance?


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Q93. In what situation, fore-closure of a life insurance policy can be initiated by the Insurer?


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Q94. In case of un-natural death or accidental death, what additional documents required to be submitted for claim process?


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Q95. If an insured wants to cancel a policy, what documents required to submitted?


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Q96. Intimation of death need to be given within how many days of death of the insured?


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Q97. What is Settlement Option in Life Policy?


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Q98. What is usual death claim settlement ratio in India?


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Q99. When a claim is considered as Early Death Claim? And how such cases are considered by an Insurance company?


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Q100. Can I take insurance on the life of my parents even if they are not dependent to me?


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