Gustavo Trías, president of the Argentine Association of Insurance Companies.
Cases of fraud in the insurance market have registered an increase in recent years, causing losses to the sector of around US$ 100 million per year, according to data from the Argentine Association of Insurance Companies (AACS), a situation that causes concern in chambers and companies that have already begun to outline new methods and strategies to combat it.
Yes ok “It is very difficult to establish the amount because there is no single record of fraudulent acts, surely today it is at least above $100 million per year”estimated Gustavo Trías, president of the AACS, in statements to Télam.
In this sense, he explained: “In home policies, for example, between four and five percent of reported claims are analyzed in depth, and it is determined that approximately 25% are fraudulent, according to AACS studies.”
“In home policies, for example, between four and five percent of reported claims are analyzed in depth, and it is determined that approximately 25% are fraudulent, according to AACS studies”
“Another singular case is the theft of automobile wheels, where there are approximately 300,000 thefts reported per year, 19% are investigated and approximately 40% end up being rejected for fraud, about 24,000 per year,” Trías added.
The director of the AACS also mentioned that there are fraudulent organizations created to profit from car accident claims“where the claims, the claimants, the medical expertise are invented; in short, cases are assembled that even, in some cases, the false claimants sue in court,” he explained.
“The different forms of fraud rotate and change, and the sector is on continuous alert to try to detect and avoid them”assured Trías, while lamenting: “All of us who are insured must pay it in the cost of our contracted insurance.”
fraudulent claims
In the same line, María Herrera, VP of Sales of Friss for Latin America, stated that “it is key and fundamental to face insurance fraud because it is an industry that participates in 3% of the GDP at the country level.”
“In Argentina, between two and three percent of the premiums go to fraudulent claims, from $80,000 million to $100,000 million a year, and this greatly affects the solvency of the industry,” Herrera added in dialogue with Télam.
For his part, the general manager of the Libra Seguros company, Juan Ignacio Perucchi, agreed with the premiums lost in the payment of fraudulent claims, and complemented with a “revealing” data: “47% of the claims paid have a component of fraud”.
“The insurance market is the main investor, therefore, these deviations in fraud are no longer applied to investments for the development of the country”at the same time that the solvency of the sector is affected, Perucchi said during the conference entitled ‘Fraud in the insurance market’ sponsored by Libra Seguros and held at the University of the Argentine Social Museum (UMSA).
Meanwhile, Herrera warned “in Argentina, 49% of the claims have suspicious elements”, and stressed that “21% of the claims, yes or yes, turn out to be fraud.”
To which he warned that “the main focus of the deceptions continues to be automobile insurance, but in economic terms, personal accidents represent the highest figures for medical treatments and the damages that these types of complaints entail.”
The search for solutions
In turn, the president of Libra Seguros, Gabriel Bussola, contemplated that “the insurance market presents worrying rates in the different dimensions of the business”, with a “strong” incidence of fraud, which must be faced and solutions sought, staff .
“From my role as a businessman, I must face the problem from an economic aspect in pursuit of the health of my company and the insurance system in general; this approach is key and fundamental to protect an industry that participates in 3% of the GDP and that should and can grow even more, and also as a promoter of a cultural change”, Bussola elaborated during the conference at UMSA.
The incidence of fraud against the insurance activity has been increasing over the years, added Trías, and explained that currently the most common cases occur in automobile, home, and occupational risk policies, but that does not mean that they have not been discovered scams to insurers in transport, surety and all kinds of risks.
“The same can be of a different nature since there are many attempts at occasional fraud carried out by opportunists, as well as criminal gangs organized to perpetrate crimes that allow them to make money, in which people who know the operation very well and generate an activity recurring”, deepened the president of the AACS.
In addition, he explained that “another of the relevant points that border on or definitively constitute a fraudulent action, according to the point of view of each one, are excessive claims; increasing them in such a way, inventing ailments, losses, which also generates damage important to the insurance ecosystem”.
