Survey uncovers sympathy for fraudsters - Update

Internal Auditor, April, 2003 by Christina Brune

NEARLY A QUARTER of U.S. adults say it's acceptable to defraud insurance companies, according to a recent study. In fact, more than one in 10 survey participants approve of submitting insurance claims for items not lost or damaged or for treatments not provided, and II percent know someone who has inflated the value of an insurance claim. Moreover, 40 percent of respondents admit that they are unlikely to report someone who has committed a fraud.

The study, which included telephone interviews with more than 1,000 U.S. adults, was commissioned by Accenture--a management and technology consulting firm--and conducted by market analysts Taylor Nelson Sofres Intersearch to examine attitudes toward insurance fraud. Researchers learned that 83 percent of those surveyed believe insurance companies are capable of identifying or preventing fraud-related property and casualty insurance claims.

Almost half of survey participants say people commit insurance fraud because they can get away with it. Moreover, two thirds of respondents speculate that insurance fraud is more likely to occur during an economic downturn than when the economy is strong. Fraudsters commit their crimes because they need money, say 30 percent of those polled. Twenty-four percent of respondents suspect that offenders believe they pay too much for insurance, and 20 percent believe people commit fraud to compensate for their deductibles.

"Fraud is a growing concern for insurers, whose aging technology and inefficient processes often prevent them from detecting fraudulent claims," says Michael A. Lucarini, a partner in Accenture's Insurance Practice. "The Insurance Services Office Inc. estimates that the cost of fraud in the U.S. property and casualty industry is approximately $24 billion, which represents 10 percent of total claims payments.

"Those committing fraud are becoming more sophisticated and advanced in their methods, although many insurance companies still lack the necessary processes and systems to detect and stop fraud," Lucarini continues. "The burden is clearly on insurance companies to ensure they have the proper tools, technologies, and skills to combat fraud."