What we will discuss

The Center of Excellence in Finance (CEF) and the Insurance Supervision Agency of Slovenia (ISA) will organize a round table on October 10-11, 2013 in the premises of the CEF, Cankarjeva 18, Ljubljana, Slovenia. Insurance frauds occur in almost every business around the world and costs businesses, and those who pay insurance premiums, billions of dollars every year. The motive most often noted for someone to commit insurance fraud is to gain (monetarily) from some act that can be blamed on the insurance business. Fraud comes in all forms and sizes. It may be a simple act involving one person or a complex operation involving a large number of people from within and outside the insurer. In accordance with the IAIS (International Association of Insurance Supervisors) Application Paper on Deterring, Preventing, Detecting, reporting and Remedying Fraud in Insurance (September 2011) frauds in insurance business could occur in the following:

• Internal fraud — fraud against the insurer by a board member, senior manager or other member of staff on his/her own or in collusion with others who are either internal or external to the insurer;
• Policyholder fraud and claims fraud — fraud against the insurer in the purchase and/or execution of an insurance product by one person or people in collusion by obtaining wrongful coverage of payment;
• Intermediary fraud — fraud by intermediaries against the insurer, policyholders, customers or beneficiaries;
• Other — fraud committed by contractors or suppliers that do not play a role in the settlement of insurance claims, and fraud by misrepresentation of insurance cover to attract investors, obtain favorable loans or authorizations or other types of favorable decisions from public authorities.

No matter the type of insurance fraud claim perpetrated by criminals, businesses often end up paying thousands of dollars through their insurance. One of the most difficult problems for businesses and insurers is the inability to accurately detect insurance fraud cases. By the very nature of the crime, it is intended to usually be subtle and well hidden by those perpetrating the fraud. As frauds in insurance business are costly both for policyholders and insurance companies, insurance regulators, insurance supervisors and insurance business should work hand-in-hand to detect such frauds and punish perpetrators.

Who should attend

The round table will be dedicated to the highest level of representatives of ministries of finance, insurance supervisory authorities and insurance undertakings of West Balkan countries. Lecturers of regulatory and/or supervisory authorities and insurance companies from different countries and international organizations will share their experiences and views regarding the detection and prevention of frauds in insurance business.