Automobile insurance fraud is an issue that has fallen on deaf ears in Taiwan’s insurance market and there is no sufficient statistics for reference. In fact, the insurance fraud is common in our insurance industry. In life insurance market, the breach of disclosure and the double insurance dispute are often involved in moral hazard. Furthermore, the abnormal losses are also found in the non-life insurance industry, especially in the marine cargo insurance, the fire insurance and the automobile insurance. This situation which leads loss ratio much higher than normal can not be neglected. Insurance fraud makes high profit especially when the economy goes to depression. The rapid growth of Insurance Fraud could be a threat to an insurance company. Thus, this research, 「The Research of Automobile Insurance Fraud」 divides the automobile insurance fraud into two major parts, one is underwriting and the other is claim. There are 20 types of automobile fraud. The top 3 causes are applying for insurance after loss on underwriting side, making up an insurance loss and making fake insurance accidents on claim side.
In order to identify, avoid and prevent the insurance fraud for insurance companies, consumers, government and other related parties, there are 4 conclusions in this research. The first is to understand and analyze the types of insurance fraud. The second is to enhance the professional training for insurance employees. The third is to conduct internal auditing. The last is to enforce legal guidance for cooperating shops and related parties.
This research concludes two ideas that could be provided to the non-life insurance operation. The first idea is to make anti insurance fraud law into practice. The contents are to enforce the function of the insurance anti-fraud institute of the R.O.C., to establish the dynamic tracking system of the insurance fraud, to set up the special telephone line for informing the crime and rewards, to amend related laws, to set up anti insurance fraud policy unit, to establish the network among the insurance industry, the medical industry, and the police, to educate more on insurance. The second idea is more cooperation to the insurance industry, including professional anti-fraud training, anti insurance fraud reporting system, insurance product design enforcement, international market linking, and social responsibility.