Real case studies on insurance fraud written by real fraud examiners Insurance Fraud Casebook is a one-of-a-kind collection consisting of actual cases written by fraud examiners out in the field. These cases were hand selected from hundreds of submissions and together form a comprehensive picture of the many types of insurance fraud—how they are investigated, across industries and throughout the world. Entertaining and enlightening, the cases cover every type of insurance fraud, from medical fraud to counterfeiting. Each case outlines how the fraud was engineered, how it was investigated, and how perpetrators were brought to justice Written for fraud examiners, auditors, and insurance auditors Other titles by Wells: Fraud Fighter and Corporate Fraud Handbook, Third Edition Edited by Dr. Joseph T. Wells, the founder and Chairman of the Association of Certified Fraud Examiners (ACFE), the world's leading anti-fraud organization, this book reveals the dangers of insurance fraud and the measures that can be taken to prevent it from happening in the first place.
In Ghana, the National Health Insurance Scheme (NHIS) introduced in 2003 mandates every citizen to have insurance cover. However, whereas all formal sector workers contribute part of their social security as premium to the scheme, those in the informal sector (who constitute about 70% of the population) are required to voluntarily pay directly into their schemes. Also, even though a proposal has been made to exempt the poor, no mechanism has been determined to identify poor households for subsidy. This study sought to determine factors that affect enrolment and to determine a practical mechanism to identify the poor for enrolment. Findings from the study show that enrolment levels in all the three district schemes visited are low. One contributory factor was that the premium levels were not affordable to many households. The flat premiums charged by all the schemes contrary to the policy to graduate premium according to income levels served as a barrier to many households. Other challenges were physical access barriers to health facilities and low public education on the scheme. The study came up with a practical mechanism to identify the poor for enrolment into the scheme.
This book was divided in to six chapters.The book is to highlight the present work in its right perspective. Some relevant literature on this type of modeling either in insurance or elsewhere are presented. In the period of dynamic indetermination in science, there is hardly a serious piece of research, which, if treated realistically, does not involve operations on stochastic process. So it is natural to find growing awareness and interest in stochastic modeling every where. An insurance system can be defined as a mechanism for reducing the adverse financial impact of random events that prevent the fulfillment of reasonable expectation of human beings. This system covers both property and human-life values. An insurance contract promises to make good to the insured a certain sum in consideration for a payment in the form of premium from the insured. Insurances can be classified in to two divisions namely life insurances and non life insurances. The non life insurances cover motor, health, fire, marine etc. A stochastic insurance model would be to setup a projection model which looks at a single policy, an entire portfolio or an entire company.
The collapse of some insurance companies coupled with little emphasis on some of the risk factors in estimating motor insurance claims would give room for unfairness in making claim.The study has revealed the difference in the contribution level to making claims This allowed for an in-depth analysis of claim variables to assist in understanding the motor insurance claims.The SIC Insurance Company Limited should give relatively high premium to new cars as compared to older ones due to their higher demand of claims.Structuring the risk factors could help actuaries concerned with motor claims to appreciate the problems and advise the underwriters accordingly.Information Bill must be passed into law in view of removing the bottlenecks associated with data acquisition which was a serious challenge of this study.It is also recommended that further study be done in other insurance companies with the view of appreciating the discrepancies that exist in valuing risk, thus help Policy makers and particularly National Insurance Commission (NIC) to fairly price motor premiums.
The life insurance industry in India grew by an impressive 36%, with premium income from new business at Rs. 253.43 billion during the fiscal year 2004-2005, braving stiff competition from private insurers. This report "The growth of ICICI Prudential Life Insurance Co. Ltd. since inception” in Indian Insurance Industry, finds that the market share of the state behemoth, ICICI, has clocked 21.87% growth in business at Rs.197.86 billion by selling 2.4 billion new policies in 2004-05. But this was still not enough to arrest the fall in its market share, as private players like ICICI Prudential Life Insurance grew by 129% to mop up Rs. 55.57 billion in 2004-05 from Rs. 24.29 billion in 2003-04.Total value of the Indian insurance market (2004-05) is estimated at Rs. 450 billion (US$10 billion). Though the focus of this market research report is on “A STUDY ON THE GROWTH OF THE ICICI PRUDENTIAL LIFE INSURANCE CO LTD., SINCE INCEPTION”, it also talks about the market size, market segmentation, and key developments in the market after 1999. The report gives an instant overview of the growth of ICICI Prudential life insurance since inception in the Indian insurance market
The focus area of this paper is on the assignment problem with budget constraints which is one of the application area of combinatorial optimization that operates on the domain of those optimization problems,in which the set of feasible solutions is discrete or can be reduced to discrete,and in which the goal is to find the best solution. It is particularly concerned with solving the unconstrained assignment problems with Hungarian algorithm and the constrained assignment problem by cutting plane or outer linearization algorithm for solving the Lagrangian dual problem in which, at each iteration,the function that approximates the dual function is optimized. The paper is divided in to two chapters. In the first chapter,the classical assignment problem,the problem of finding optimum (minimum or maximum) cost or profit assignment a set of workers or resources to jobs or activities to gather with its mathematical formulation,solution methods and special cases in assignment problems were considered. Under the second chapter, we have considered generalization of the classical assignment problem concerning resource(or budget) constraints, due to the variety of real life problems.
Insurance is a device for indemnifying or guaranteeing an individual against loss. Reimbursement is made from a fund to which many individuals exposed to the same risk have contributed certain specified amounts, called premiums. Payment for an individual loss, divided among many, does not fall heavily upon the actual loser. The essence of the contract of insurance, called a policy, is mutuality. The major operations of an insurance company are underwriting, the determination of which risks the insurer can take on; and rate making, the decisions regarding necessary prices for such risks. The underwriter is responsible for guarding against adverse selection, wherein there is excessive coverage of high risk candidates in proportion to the coverage of low risk candidates. In preventing adverse selection, the underwriter must consider physical, psychological, and moral hazards in relation to applicants. Physical hazards include those dangers which surround the individual or property, jeopardizing the well-being of the insured. The amount of the premium is determined by the operation of the law of averages as calculated by actuaries.
A wireless mesh networks (WMNs) has emerged recently, WMN consist of two types of nodes mesh routers and mesh clients.WMN is dynamically self-organized and self-configured, with the nodes in the network automatically establishing and maintaining mesh connectivity among themselves. Channel assignment is a critical issue in WMN which is the mapping between the available channels and the radios at each node such that the network performance is optimized, and hence the focus of this work along with static channel assignment, multi-radio, multi-channel. Multi-radio MAC can potentially achieve higher network capacity than single-radio MAC. We design and implement a new agent (DSBCA) distributed channel assignment spanner base, the routing protocol Optimize the network performance considering the throughput, end-to-end delay, connectivity and the interference of our channel assignment algorithm. Base on the network simulations NS2.34 on Linux Fedora and our proposed channel assignment algorithm improved the throughput, minimal-connectivity preserving channel assignment algorithm.
This book is addressed to students from economic higher education system and to the professionals active in financial accounting, insurance, reinsurance and general inventory field. The book is structured in five chapters as follows: Insurance and Reinsurance - Forms of Protection Against Risks, Elements of Insurance. The Insurance Contract, Insurance and Reinsurance Market, Financial Insurance, The Accountancy of the General Inventory of the Patrimony.
Assignment is a crucial topic in commercial law, and this new work by Gregory Tolhurst is the most comprehensive work on the assignment of contractual rights ever published. It seeks to explain the existence, meaning and application of the rules governing the assignment of contractual rights and it does this by reference to the idea that assignments involve transfers. The book is logically structured to follow the issues that arise in planning, drafting and enforcing an assignment, including: - what is meant by 'assignment'; - what is the distinction between legal and equitable assignments; - how an assignable contractual right is identified; - what formalities apply to assignment; and - what rights and remedies are available to the parties to an assignment. The topic of assignment is of such universal importance to commercial lawyers that all practicing lawyers will find this work invaluable. However, the work will also be required reading for academics teaching contract, equity and personal property.
The protection of policyholders'' interests and customer satisfaction are the most important issues which are to be taken care of after the privatization of the industry. In view of the above said issues an attempt has been made in the present research work to study the service quality perceptions and assess the attitude of life insurance policyholders. The study envisages assessing the attitude of the policyholders towards the phenomenon of privatization, the changes brought in the industry after privatization and the consequent satisfaction levels. The present study has been carried out to study the progress and trends in the life insurance industry in India after privatization;to conduct plans/policies comparison of different players;to probe into the availability of insurance services as to coverage and distribution reach;to seek opinion of customers regarding premium rate structure;to find out customer satisfaction towards plans/policies, distribution channels and promotional measures and to study customer satisfaction levels regarding claim settlement and grievance handling mechanism.
The Evil Within: The Assignment – это первое из двух дополнение к The Evil Within, главной героиней которого является Джулия Кидман, напарница детектива Себастьяна Кастелланоса. В этом дополнении игроки получат часть ответов на те вопросы, которые у них остались после финала оригинальной игры.
Assignment Problem is one of the first fundamental problems in the area of combinatorial optimization. Despite its historical roots, the problem has tremendous importance to date, due to its numerous real life applications in like facility location, personnel scheduling, job scheduling, production planning, project assignment, task assignment, time-tabling, vehicle routing, storage space allocation, etc. This book comprises some real life assignment and related problems involving imprecise cost/time parameters. In order to represent those imprecise parameters, interval numbers have been used here as this representation is the best among others. The associated problems have been solved using Genetic Algorithm efficiently. A salient feature of this book is that most of the algorithms have been written in a lucid manner with suitable examples using figures. This book should interest academicians, OR/GA practitioners and executives of different industries and business organizations.
The Challenges & Prospects of District-wide Mutual Health Insurance Schemes in the Upper West Region: A Cross Sectional Study of Nadowli District Scheme is the first book to provide a comprehensive overview of how Healthcare is financed under the National Health Insurance concept in Nadowli District since its inception in 2003.The study was a descriptive cross-sectional in design aimed at eliciting information about perception of community members, the health facility, and the scheme about premium levels, benefit package, quality of service, funding of scheme and dependency of exempted registrants on the scheme. The study employed questionnaires administered to households, health facilities and scheme managers. The study identified the challenges & prospects of Nadowli DWMHIS and made recommendations to improve sustainability.This book offers guidance to Health Insurance Practitioners, Managers, Researchers, Students and Policy Makers on how to manage Insurance Schemes in other to ensure viability and sustainability. This book sets standard, both in theory and practice, for future work in field of Health insurance and Healthcare financing in Ghana and other developing countries.