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Ethics and Insurance Fraud

2021-01-07 06:00:42

It is always disturbing to witness fraud. Who wouldn't believe we're better than this? It is especially discouraging at a time when systems that support our local and national communities are already under severe strain.

Insurance fraud is all too often seen as a victimless crime. Insurance companies are depicted as anonymous entities. It is believed that these colossal organizations made up of nameless people can easily afford to have their wallets taken. While most people know better, it is not widely understood.

According to the FBI, the total cost of insurance fraud (non-health insurance) is estimated at more than $ 40 billion per year. A simple distribution, then, suggests that the average American family pays between $ 400 and $ 700 a year in the form of increased premiums due to insurance fraud.

While some of the public's cynicism has been deserved, some has been fueled by individuals and entities abusing social media platforms.

These actions and their consequences increase the need for clarity about ethical behavior.

Theft, like looting, is wrong despite the size or wealth of the victim. Strong and targeted clarity in this regard will help discourage insurance fraud, as well as other cases of fraud that undermine the public interest. There is no middle ground in this matter. There is only right and wrong.

It's no secret that we live in a cynical age. Aircraft manufacturers, social media platforms, financial institutions, news outlets and elected officials, to name a few, are often viewed with skepticism. Of course, our own insurance industry is sometimes not trusted by the public. This mistrust is now evident as hundreds of insured parties have filed lawsuits against carriers because business interruption insurance does not cover claims related to COVID-19-induced losses.

While some of the public's cynicism has been deserved, some has been fueled by individuals and entities abusing social media platforms. Not every person or organization drenched in a tweet storm deserves to get wet.

While ethical behavior has a moral component, it also inspires a practical good.

As risk management professionals, we realize that ethical behavior generally results in safe behavior. If I had the time and you had the patience, I could name hundreds of examples. Since both time and patience are very scarce resources in these troubled times, here are just a few examples:

  • Driving a well-maintained motor vehicle while obeying the rules of the road will more often than not result in a safe, peaceful journey.
  • Providing employees with a well-designed work environment and personal protective equipment (PPE) reduces workplace injuries and deaths.
  • Companies that take the time and spend the money it takes to properly select, train and equip customer-facing employees will be the target of fewer lawsuits with customers.
  • Full testing of new products will also result in fewer lawsuits.

In each of these cases, ethical behavior contributes to safe results.

I believe many people would choose to behave ethically when everything else is equal. The reason some choose to deviate from this path is when they think it is more likely to lead to short-term success, otherwise known as instant gratification. This deviation is also called a & # 39; shortcut & # 39; or & # 39; path of least resistance & # 39; mentioned.

Business reversals, setbacks, and financial setbacks can also change one's ethics.

Of course, long-term failure and at best only short-term success are the most likely outcomes when ethics are abandoned or bent. Unethical behavior often leads to lawsuits, reputation damage, customer turnover, staff turnover, significant supplier turnover, business failure, and even time spent in a correctional facility.

I feel obliged to add that ethical behavior is no guarantee of success, although it would certainly be nice if it did. A bad service model or poorly designed product line usually ends in failure, despite ethical choices.

However, you can still look at yourself in the mirror.

About Kevin McPoyle

McPoyle is president and co-founder of KMRD Partners Inc., a risk management consultancy and P / C insurance broker based in Warrington, Limerick, and West Chester, Penn.

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