Abstract:

Insurance fraud is a serious problem, which impacts all insurance markets in Europe. Losses of insurers reach as much as 10 per cent of expenditure related to payment of claims and benefits (Insurance Europe, 2013: 5). Apart from measurable direct financial losses, insurers bear intangible costs in the form of complication and prolongation of claim adjustment processes as well as they lose trust and reputation among clients. Numerous sources indicate insurance fraud as one of the main threats for the development of insurance markets (Derring, 2002) (World Economic Forum, 2015: 80; PwC, 2015: 18), (EIOPA, 2016: 35). Over the years, insurers have managed to create numerous methods of preventing crime (Hymes, Wells, 2013). They are based on using IT tools and multidimensional analyses as well as exchange of information about clients, damages and the objects of insurance. However, fighting frauds is hindered by a serious problem of how insurers are perceived and also by social acceptance for committing extortions (Karsten, 2011). People who are inclined to commit an insurance fraud act on their own or they act as members of an organised crime group. In both cases, the decision to commit an extortion depends on the so called crime triangle – that is motivation (usually economic), opportunity (chance) and rationalisation (Cressey, 1973: 30).Additionally, the perpetrator ponders the ethical risk connected with the committed offence (Posner, 2004) (FRISS, 2016: 6; Kassem, Higson, 2012: 191-195). It is related to the level of social acceptance for a given type of crime. In the case of economic crimes it is higher than in the case of serious criminal offences.