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Application Fraud Indicators

Name

Application Fraud Indicators

Description

Indicators Of Application Fraud

  • Most applicants for insurance coverage are trustworthy, but some are dishonest. Therefore, it is appropriate for the agent to review all applications for possible fraud. Determining the "fraud potential factor" of any application is facilitated when the agent is familiar with various fraud indicators.
  • These indicators should help isolate those applications which merit closer scrutiny. No one indicator by itself is necessarily suspicious. Even the presence of several indicators, while suggestive of possible fraud, does not mean that a fraud is being committed. Indicators of possible fraud are "red flags" only, not actual evidence.
  • Suspicious applications may have to be accepted for lack of conclusive evidence of fraud; however, the underwriter should be made aware of the agent's suspicions, and subsequent referral to NICB for further review may be appropriate.

General Indicators of Application Fraud (download the program for the rest of the indicators)

Standard (Non-IT) Audit Program

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Type

Procedures

Language

English