Insurance Fraud - Nothing but a phenomenon that can be caused by the active process of developing economic relations of a new plan in the history of the modern Russian Federation. Thus, insurance activities designed to reduce financial risks, increase stability and creditworthiness, as well as stimulate entrepreneurs ’initiatives, due to the operation of schemes of an illegal nature, cannot competently organize the accumulation of a trust fund in a sufficient amount of funds. That is why today significant damage is done to both individual individuals and legal entities, and to the state in the general sense.
Situation for today
Characterizing insurance fraud litigation says that the rate of criminalization of the insurance market in accordance with the estimates of numerous researchers to date is able to get ahead only of crime, relevant in the virtual space. In addition, losses from shadow turnover, which are identified annually, currently reach four hundred million dollars. According to statistics, for example, over the past and first half of this year, through state law enforcement agencies, more than three hundred thousand facts were recorded in relation to economic fraud. In this aggregate insurance fraud occupies a very significant part. More specifically, the exact figure is one thousand five hundred cases. It is advisable to note that the presented indicator can be significantly increased. To do this, you only need to pay close attention to the complexity of identifying criminal schemes and their eccentricity.
Basics of Activities
In order to consider in detail insurance fraud (UK), it would be appropriate to identify the basics of direct activity. So, in accordance with the definition, an insurance business is nothing but the provision of measures designed to protect the property interests of interested individuals and legal entities in the event of a strains incident. The basis of the activity, which is based on the contractual aspect, is the occurrence of an insurance interest in a particular object by the insured or the occurrence of an insured event (for example, during the transportation of goods). In order to insurance fraud was minimized, the state is taking appropriate measures. So, regulation of relations in the insurance sector at the state level is carried out strictly according to the Civil Code of the Russian Federation.
Principles of functioning of the insurance market
Today, the functioning of the Russian insurance services market is based on the following principles:
- The object of insurance is nothing more than personal property interests. Among them are harm to health, survival to a specific age, and so on. In addition, today the values of material nature are actively insured against theft, damage, destruction, as well as other aspects related to disposal, use or possession. Slightly less often in the insurance procedure involved in the implementation of entrepreneurial activities or compensation for harm caused to third parties.
- The relevance of a transaction is revealed by finding the parties in good faith ignorant of those events regarding which the contract is concluded. It is important to note that the event, being the subject of insurance risk, one way or another should have signs of probability and chance.
- Compensation, in accordance with article 929 of the Russian Civil Code, should be understood as the insurer's obligation to reimburse losses incurred upon the occurrence of an insured event fixed in the contract upon the fact. It must be added that in this case, the amount of the insured amount should not be higher than direct damage.
- In good faith, the need should be considered for providing evidence that an insured event has nevertheless occurred. It is logical that this operation should be carried out by a person who makes claims for damages. It is important to note that the recognition by the insurer of the claim, as well as the corresponding compensation payment automatically transfers to its evidentiary burden to other interested parties. These include persons responsible for financial losses, harm caused, and so on, as well as reinsurers.
- By subrogation, in accordance with Article 965 of the Russian Civil Code, it should be understood that the transfer of rights from the insured person directly to the policyholder in actual obligations and within the framework of the paid monetary compensation for the presentation of certain claims against the person who is responsible for causing losses.
It is necessary to add: through article 928 of the current Civil Code, interests are envisaged, which in any case are not subject to insurance. In addition, under article 933 it is impossible to insure the risks of business and liability (article 932 of the current Civil Code) of individuals and legal entities when they are not among the insured.
Insurance market participants who take certain actions aimed at insurance fraud (as a rule, a violation of the rights of the state or individual individuals, legal entities), cause this or that damage and are qualified as fraudsters through the Criminal Code of the Russian Federation.
Fraud Classification
In the days of the USSR, the only structure that was engaged in insurance activities was Gosstrakh. Characterizing practice insurance fraud of that period shows that schemes for the appropriation of insurance payments, illegal enrichment and other illegal actions were individual. As a rule, they related to fictitious carjacking, cattle death and other dramatizations.
In 1992, the situation changed radically, because the Law on the Organization of Insurance was adopted. The situation of the state was further aggravated after the introduction of the system of compulsory insurance procedure in respect of civil liability in 2002 through the federal legislative act number forty.
Characterizing litigation insurance fraud Practice shows that the active development of the private sphere of insurance services, as well as innovative technologies in a very short period of time created a criminal market. It was on it that fake policies, the organization of fictitious accidents, the receipt of court decisions of a formal nature, and so on were introduced. Absolutely all crimes in the field of insurance are classified depending on the direction against interests:
- The policyholder (in other words, the acquirer benefits).
- The insurer.
It would be appropriate to consider insurance fraud (UK RF) and the corresponding varieties in more detail.
Insurer's Crimes
In the previous chapter, it was noted that crimes can be carried out both by the insured and by the insurer. So, in the latter case insurance fraud (Criminal Code of the Russian Federation) is made by employees of the insurance organization directly inside it or through external entities. These include, for example, intermediaries of various levels. It is important to note that unlawful actions against the insured are usually committed by employees of the structure or strass intermediaries; fictitious enterprises belong to a separate category of crime. Today, in accordance with the Russian Criminal Code, the following types are distinguished: insurance fraud:
- Article 325 - damage, destruction or theft of documentation, seals and other attributes of insurance activity.
- Article 201 - abuse of authority by employees.
- Section 204 - bribery.
- Section 159 (5) - Insurance fraud.
- Article 160 - misappropriation of property complexes or embezzlement.
- Section 292 - Forgery.
- Articles 173 and 171 are illegal and fictitious business activities, respectively.
- Article 291 is a bribe.
It’s important to know what's on today vehicle insurance fraud Seventy percent of all insurance crimes. This information was provided by the Federal Service, which is responsible for market surveillance of insurance services. It is necessary to add that the general classification of types of fraud is presented in article 159 (5) of the Russian Criminal Code under the name “Insurance Fraud”. It is produced, as it turned out, by the initiator of the crime.
Victim Fraud
Today, absolutely any crime (for exampleinsurance fraud. 159 (5)) one way or another has an injured party. Actions of a criminal nature that relate to the victim are endowed with direct qualifications. Nevertheless, the victims often fictitiously produce the situation so that it becomes similar to the insured event. In this way, insurance fraud (article 159, Clause 5) often involves damages. It is possible to distinguish between the real and the imaginary victim. For this, one should rely on the identification of evidence of fraud in fact, as well as through the emission of their portrait from a psychological point of view. So, the behavior of the imaginary victim is very different from the behavior of a real person.
For example, it is possible to stage the damage to property complexes, an accident (traffic accident) or specifically harm your own health, but not all situations contain evidence of a crime that is objective in nature. Thus, the absence of facts may lead an actual investigation to the fact that the imaginary victim receives liability for insurance fraud and, of course, damages.
Crimes by policyholders
Today, the most common are illegal schemes for obtaining monetary compensation in accordance with the policies of the compulsory insurance procedure in respect of civil liability (similar name - CTP). There are a large number of illegal insurers misleading the insured. Thus, they manage to get substantial sums of money. The most striking example of a fraud scheme is the staging of a large-scale accident, where an expensive car takes part, for which several individuals have a power of attorney. So, a group of criminals, which has compulsory insurance policies, applies to several insurance institutions for compensation in accordance with one case.A similar approach to criminal structures today brings income that amounts to tens of thousands of dollars.
What else?
Currently, there are many methods of misleading individuals through the implementation of fictitious policies. In addition, the signing of agreements that contain knowingly false conditions is actively practiced. Such varieties include, for example, long-term accumulation policies at foreign enterprises or insurance “traps” in election races. By the way, the first type is distinguished by the fact that the policyholder receives a proposal not only regarding direct participation in the system, but also through attracting a clientele to obtain illegal wages for the implementation of policies.
A responsibility
Under the current Penal Code personal insurance fraud, for example, is one aspect of the whole system of crimes. That is why the punishment strictly depends on the severity of the damage that has been done. In accordance with article 159 (5) of the Russian Civil Code, the following measures are currently envisaged:
- A fine of one hundred twenty thousand rubles.
- Forced labor for a period of three hundred and sixty hours.
- Arrest for a period of four months or more.
- Restriction or imprisonment up to and including two years.
In addition, some parts of the article provide for more severe penalties. As a rule, they relate to crimes committed by prior conspiracy by a group of persons, persons who used their own official position or carried out embezzlement on an especially large scale. It is important to note that in practice, the punishment of fraudsters primarily depends on the ability to identify the corpus delicti. The latter one way or another serves as a key factor for referring a case to the judiciary.
Arbitrage practice
Today, in order for the consideration of cases related to insurance fraud to go smoothly, there are relevant explanations of the Plenum of the Supreme Court regarding the standards for the use of Article 159. In particular, the judicial authorities undertake to be aware of the following facts:
- Obtaining property complexes is considered as fraud only when, at the time of seizure, the accused had the goal of not fulfilling his own obligations and assigning the values of material nature to his own disposal.
- Abuse of trust. In other words, the voluntary transfer of property complexes to the victims, subject to the performance of actions under the influence of something or someone.
- In fact, access to property complexes should in any case be accompanied by a transfer of powers in accordance with its management, as well as an order.
Persons participating in such frauds belong to the management team that makes decisions on payments or to the expert department that gives an opinion on the condition of the car.