Vyšetřování pojistných podvodůa jejich prokazování pracovníky pojišťoven
Investigation of Insurance Fraudsand Proving them by Insurance Employees

Summary/Abstract: Criminal offence of the insurance fraud is always aimed against the property of legal per-sons (insurers), therefore we can presume a partial latency of the criminal offences that cannot be accurately estimated. Both of the Criminal Police and specialized departments of insurance companies are engaged in detection of this kind of criminal offence. Incentives to insurance fraud investigation are obtained by police from insurance company representatives and from their own operational activity. While detecting litigious loss occurrence the insurance companies use predictive detection methods, especially screening of subjects (client, insurance agent, etc.). The software tools as a special statistic modelling algorithms based on evaluation of historical data and reporting service that automatically report activity of monitored subjects are used. Proving insurance fraud is a complex process, however it can be said that the insured event is fraudulent event in the case that fraudulent conduct applies only to the portion of a raised claim.

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