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"Do not sign a blank insurance or takaful application, or insurance or takaful
claim form" |
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The essential components of an insurance fraud are:- |
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Intent to deceive
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Desire to induce insurance company or takaful operator to pay more than it otherwise
would.
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Examples of insurance fraud
Fraud occurs in all classes of insurance. Examples of insurance fraud include:- |
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Creating a fraudulent claim |
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Overstating amount of loss |
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Misrepresenting facts to receive payment |
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Bogus agents/Sale of forged cover notes |
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Sale of insurance by an unlicensed insurance company or takaful operator or someone
purporting to be an agent of an insurance company or takaful operator.
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Sale of forged cover notes by touts or organised syndicates to those who, knowingly
or unknowingly, purchase the cover notes for the purpose of securing road tax for
their motor vehicles.
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Why should you care about insurance fraud?
It is a misconception to regard insurance fraud as a 'victimless' or 'hidden' crime
because, in reality, it costs everyone. Insurance fraud results in:-
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Higher premiums and higher prices for goods and services
The costs incurred by insurance companies or takaful operators to combat and pay
fraudulent claims will ultimately be passed on to the insuring public in the form
of higher premiums. Insurance fraud also results in higher prices for goods and
services as businesses pass the higher cost of insuring their property and stock
to their customers.
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Reduced availability of insurance
Insurance companies or takaful operators may impose stricter underwriting requirements
and restrict their scope of coverage to cap losses due to fraud. Insurance companies
or takaful operators may also withdraw cover for sectors that are fraught with insurance
fraud.
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Delayed settlement of genuine claims
Insurance companies or takaful operators are wary of fraud and will carry out thorough
investigation where fraud is suspected. The stringent claims settlement procedures
put in place by insurance companies or takaful operators to weed out fraud may inevitably
result in the delayed settlement of genuine claims.
As a consumer, you can play a role to combat fraud. Make sure that you do not knowingly
commit fraud or assist others to commit fraud. The insurance company or takaful
operator has the right to deny liability and reject your claim if there are elements
of fraud established in your claim.
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How do you protect yourself? |
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Be wary of unregistered insurance agents. Before purchasing insurance, contact your
insurance company or takaful operator or Persatuan Insuran Am Malaysia (PIAM), the
Life Insurance Association of Malaysia (LIAM) or the Malaysian Takaful Association
(MTA) to ensure the agent is an authorised agent.
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Avoid paying premiums in cash. Opt to pay for premiums by cheque or money order.
Made payable to the insurance company or takaful operator instead of the agent.
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Make sure you receive a written policy after payment of your first premium.
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Immediately examine your insurance policy to ensure the coverage is what you have
requested for and ensure that the premium amount paid is reflected in the cover
note/policy. Request for a receipt as evidence of payment of premium.
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Do not sign a blank insurance or takaful application, or insurance or takaful claim
form.
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Be suspicious if the price of insurance or takaful seems suspiciously low from other
insurance companies or takaful operators.
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If you meet with an accident, be careful of strangers who offer you quick cash or
urge you to deal with specific workshops, medical clinic or law firm. They could
be part of a fraud syndicate.
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Insist on detailed bills for repairs and medical services rendered and check for
accuracy.
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Discreetly contact your insurance company or takaful operator, PIAM/LIAM/MTA or
the police if you are being defrauded or have been/are being persuaded to take part
in a fraud. Provide as many details as possible about the incident - name of the
individual(s) involved, amount, date(s), and type of fraud.
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