How To Recognize, Prove And Testify Insurance Fraud

Author: Barry Zalma
Fraud is a common problem in the insurance industry. It is a costly affair for both holders of the policy and insurance companies in all sectors of the industry. A recent study indicates that false claims account for a considerable part of all claims that the insurers receives, and cost a lump sum of money annually. Fraud has been occurring in various stages in the process of an insurance transaction. It can take place either in the application process, when the individual is a policyholder or also by third-parties.

Here is the sequence of incidents of fraud recognizing to fraud testifying by an insurance company.
1. Recognizing false documents
There are some obvious documents that could appear sophisticated. The claim handler must recognize that not all documents are valid. Investigation can establish the truth or falsity of a document.
2. Fake Art or Jewelry Appraisal fraud
To discover fraud, it is essential that the appraiser be interviewed and shown the original. The investigator must understand jewelry description modes and fine arts description modes. The investigator must also obtain photographs depicting the items.
3. Proof of civil insurance fraud
Each element of fraud must be proved by a preponderance of the available evidence that the insured misrepresented a fact, that the fact misrepresented was material. Had the insurer known the true facts it would not have issued the policy on the same terms or would not have paid the claim. Each element of fraud must be proved by a preponderance of the available evidence.
4. Testifying on Fraud
Fear of prosecution, they will testify to creating false appraisals on the request of the insured. Fear of prosecution, the insured admits to creating false documents. False document creation is proved by the testimony of the vendors. It is necessary to prove the fact that the insurer was deceived.

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