Monday, June 24, 2019

Ghost Fraud threatening insurance company in Indonesia

Travel Insurance has become a good friend for Risa (29) and Rani (35) who often travel abroad. Both women have both experienced benefits from one type of insurance. 

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Risa has experienced baggage constraints because her belongings were briefly to Hong Kong when she was on a vacation to Tokyo, Japan. Although the baggage is not lost, Risa learns from her experience that filing a travel insurance claim turns out to be very easy and she feels very helpful.

"Because the baseball is lost, my claim is scorched, but helped greatly because the claim process went properly, " babble clerk in one of these government companies.

If Risa is helpful in terms of luggage, Rani is easy to do in health matters. January 2019 ago, business analyst in one of the IT companies in Jakarta was first trying to use travel insurance in Vegas, USA (USA). A sore throat pain he suffered during a business trip forced Rani to take medication in one of the hospitals in Vegas.

 "All medical expenses, medical treatment and all kinds of covered insurance. So indeed, travel insurance is a mandatory requirement for a business trip, "he explained.

Unfortunately, for insurance companies, this insurance claim is precisely a spectre. A number of persons incorporated in a syndicate make use of gaps in the ease of filing claims for fraud or fraud action.

Read Also : Familiarise yourself with Chubb travel insurance before going sightseeing

Cheating mode 

According to the Indonesian General Insurance Association (AAUI), the cheating action on this insurance claim occurs at least three types of insurance in the general insurance company in Indonesia. First is travel insurance. Second, motor vehicle insurance. The last is shipping insurance (marine insurance). 

The cheating mode of three types of insurance is varied. There are two modes of cheating in travel insurance. First, claims claimed to be lost or stolen luxury goods purchased overseas. In fact, goods purchased are counterfeit goods. The second mode is to make a withdrawal of treatment abroad.

The illustration is this: once the consumer buys travel insurance, the perpetrator buys a mock-branded item in the destination country and claims to lose the item. Consumers then claimed to have lost goods to the insurer and admitted that the branded goods he purchased were original items by listing the payment notes and original forged certificates and false police reports.

The second mode is the cost of treatment in overseas. The way is not much different, namely to include a variety of fake documents including payment receipts abroad.

"All documents are forged, ranging from the certificate of luxury goods purchase until the complaint letter lost the police abroad and also the medical receipts abroad. " Jelas executive Director AAUI Dody AS Dalimunthe to Tirto. "That's all we know from the results of the internal investigation of each insurance company that got the claim."

Just like travel insurance, the cheating mode on shipping insurance is generally divided into two ways. First, the perpetrators reported sinking the ship due to storm damage. Secondly, the perpetrator reported the loss suffered by the shipment of goods lost on the sinking vessel. Indeed, the document of ship ownership and also containers of goods is a false document.

"Because the sinking ship and lost goods due to sunken ship is certainly difficult to check the truth. But we found evidence that the ship was apparently sold in a stripped down manner first, "

Meanwhile, the mode of cheating on motor vehicle insurance is by accident intentionally involving luxury cars. The illustrations are this: consumers buy luxury cars and insure their car engines and other components are replaced with inexpensive components. Afterwards, the luxury car was deliberately involved in an accident so that claims could eventually be filed. 

The perpetrators of this insurance claim is incorporated into an insurance crime syndicate in Indonesia.

Read Also : Important aspects to consider in buying car insurance

Loss of billions Rupiah 

One of the insurance companies that contributed to the loss of this cheating action is MNC Insurance. President Director of MNC Insurance Sylvy Setiawan admitted that it has received a travel insurance claim that has an indication of cheating since 2018 then with a total loss is estimated at RP100 million.

"There are two claims that we have paid for approximately RP20 million due to loss claims according to US reasonable. But, because there are repeated claims in the same mode, we finally did an internal investigation into the country concerned and we found this act of fraud, "

In addition to MNC Insurance, there are 13 other insurance companies that suffer from similar fraud. Bess Central Insurance is one of them. The company is experiencing a similar case for the type of motor vehicle insurance. 

President Director of Bess Central Insurance Sekar Tunggal revealed, cheating in this motor vehicle insurance has occurred since 2012. The action of cheating is done by buying motor vehicle insurance products in many insurance companies. 

Bess Central Insurance itself receives two claims related to motor vehicle insurance with a nominal of each reaching hundreds of millions of rupiah. However, the company refused to disburse the claim because it found various gaffe when searching for insurance claims. One of the anomalers is the practice of Congkalikong among fellow lawyers regarding this insurance claim.

AAUI Checking 

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To minimize the vulnerability of cheating on insurance claims, AAUI has made AAUI Checking. AAUI Checking is a data exchange and information system between insurance companies that was built since December 2016. The system that is still being developed is almost similar to BI Checking by Bank Indonesia. 

AAUI Checking contains a negative list of the insured or customer as well as other parties involved such as hospitals, clinics, workshops, and agents, compiled by members of the association. The list can be used by members of the association as an initial warning in selecting prospective insured, so that fraud or fraud can be prevented as early as possible.

The 2019 insurance Fraud survey conducted by the FRISS agency, meanwhile, phrasing that insurance fraud is a global problem. In the US alone, the insurance company suffered a loss of more than 34 billion U.S. dollars along 2018 due to fraudulent insurance claims. The phenomenon of travel insurance fraud and motor vehicle insurance has also occurred respectively in the UK in 2016 and Singapore in 2017 with different modes.

Singapore's General Insurance Association (GIA) General Data, there are approximately 160 thousand motor accidents reported in 2016 with a nominal claim of close to 500 million Singapore dollars. One fifth of the report is estimated to be a fraudulent claim that equals 100 million Singapore dollars. In the last six to seven years there are five major syndicate perpetrators of motor vehicle insurance fraud in Singapore.

The FRISS report (PDF) mentions the importance of collaboration between insurance companies and even to the global level. The cooperation of the insurance company can be a merger of data so that the entire insurance company benefit to track and fight against perpetrators of an organized insurance claim

"The cooperation between data exchange can prevent the action of fraudulent insurance from one country to another. Perpetrators of an insurance fraud will always look for the weakest point of the insurance company, "Write FRISS.