Source: Asia Insurance Review
What is insurance fraud?Insurance fraud or takaful fraud is any deliberate deception/dishonesty committed against or by an insurance company or takaful operator, insurance or takaful agent, or consumer for unjustified financial gain. It occurs and may be committed at different points in the transaction by different parties such as policy owners, third-party claimants, intermediaries and professionals who provide services to claimants. The nature of these frauds may vary from an inflated/exaggerated value of a legitimate claim to a completely fabricated or bogus claim where losses never really occurred.
"Do not sign a blank insurance or takaful application, or insurance or takaful claim form"
The essential components of an insurance fraud are:-
Intent to deceive
Desire to induce insurance company or takaful operator to pay more than it otherwise would.
Examples of insurance fraudFraud occurs in all classes of insurance. Examples of insurance fraud include:-
Creating a fraudulent claim
Staged accidents - e.g. by 'oil spillage' or staged chain-collision - to get the custody of the vehicle(s) for repairs.
Bogus claim for an accident or injury that has never happened.
Claiming against a personal accident insurance policy for self-inflicted injuries.
Staged slip and fall accidents.
False claim of foreign object in food or drink.
Faking a death to collect benefits or filing a false death claim.
Staged burglary, theft or vandalism.
Arson.
Staged motor theft.
Staged homeowner accidents.
Overstating amount of loss
Inflated or 'padded' claim where the extent of damage or injury sustained in a genuine accident is exaggerated
Inflating value of items taken during a burglary/theft.
Medical service providers inflating medical bills.
Misrepresenting facts to receive payment
Making multiple claims by having multiple insurance covers with different insurance companies or takaful operators for one vehicle and for a particular accident.
Claiming prior damage occurred in the current accident.
Claiming a partial or total disability for a minor injury.
Receiving disability payments while working elsewhere and conducting same or similar work duties.
Medical service providers charging for services not rendered.
Claiming false disability.
Medical service providers giving unnecessary medical treatment.
Charging for non-provided medical tests.
Bogus agents/Sale of forged cover notes
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.
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.
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:-
Higher premiums and higher prices for goods and servicesThe 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.
Reduced availability of insuranceInsurance 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.
Delayed settlement of genuine claimsInsurance 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.
How do you protect yourself?
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.
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.
Make sure you receive a written policy after payment of your first premium.
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.
Do not sign a blank insurance or takaful application, or insurance or takaful claim form.
Be suspicious if the price of insurance or takaful seems suspiciously low from other insurance companies or takaful operators.
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.
Insist on detailed bills for repairs and medical services rendered and check for accuracy.
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.
Khamis, 31 Julai 2008
insurans ialah perlindungan bukan pelaburan
Tulisan ini bertujuan memberi kefahaman bahawa insurans atau polisi insurans yang dibeli merupakan satu langkah perlindungan dari risiko kerugian sekiranya keadaan yang "dijanjikan" dilindungi berlaku.Insurans motor umpamanya, merupakan satu perjanjian antara syarikat insurans dengan pemegang polisi untuk menggantikan kenderaan yang diinsuranskan kepada keadaan sebelum kejadian yang menimpa yang pula dilindungi oleh polisi tersebut.Apabila berlaku kemalangan umpamanya,polisi yang dibeli itu akan menggantikan kereta kepada keadaan sebelum kemalangan tersebut.Tetapi secara praktikal adalah sukar menggantikan kereta kepada keadaan sebelum kemalangan,maka nilai semasa kereta tersebut diambil kira dalam menentukan jumlah penggantiannya.Maknanya,pemilik akan mendapat kembali kereta tersebut pada nilai semasa sebelum kemalangan itu.Dengan ini juga bermakna pemilik tidak mendapat apa apa keuntungan dari tuntutan polisinya tetapi mendapat kembali nilai keretanya serta mengelakkannya menanggung kerugian.Itulah konsep dan tujuan Insurans dibeli bukan untuk mendapatkan keuntungan.
dengan kata kata lain,insurans bukan satu bentuk pelaburan seperti saham atau simpanan bank.Ianya merupakan perbelanjaan mengurus yang harus ditanggung oleh pemilik harta yang berisiko kerugian.
Dengan penerangan ringkas ini,diharap dapat memberi kefahaman agar tidak lagi berlaku salah faham yang mungkin menyebabkan ada pihak yang beranggapan insurans adalah satu penipuan atau perniagaan yang hanya pandai mengambil wang orang ramai tetapi berbelit belit ketika membuat bayaran tuntutan.
dengan kata kata lain,insurans bukan satu bentuk pelaburan seperti saham atau simpanan bank.Ianya merupakan perbelanjaan mengurus yang harus ditanggung oleh pemilik harta yang berisiko kerugian.
Dengan penerangan ringkas ini,diharap dapat memberi kefahaman agar tidak lagi berlaku salah faham yang mungkin menyebabkan ada pihak yang beranggapan insurans adalah satu penipuan atau perniagaan yang hanya pandai mengambil wang orang ramai tetapi berbelit belit ketika membuat bayaran tuntutan.
Selasa, 29 Julai 2008
e INSURANS
Pada 1/1/2005 bank negara telah memperkenalkan e INSURANS bagi semua urusniaga insurans motor.Berikutan dengan itu,semua agen insurans am yang hendak menjalankan urusniaga dikehendaki memiliki komputer dan internet.Semua cover note dikeluarkan secara online dan pengesahannya dibuat serta merta oleh JPJ.
Dengan perlaksaan ini,cover note secara manual tidak lagi sah dan pengeluarannya dibuat melalui komputer dan internet.Perlaksanaan e INSURANS ini juga menandakan berakhirnya segala penipuan insurans yang sebelum ini banyak dilapurkan.Agen agen insurans tidak lagi mengeluarkan cover note sewang wenangnya sebaliknya sebarang cover note yang dikeluarkan akan mudah dipantau oleh prinsipal.Perlaksanaan ini juga memudah dan mempercepatkan urusan pembaharuan road tax.
Selain dari itu perlaksanaan e INSURANS juga menjamin bayaran premium sampai kepada prinsipal tepat pada waktunya.Agen tidak lagi mempunyai ruang untuk menggunakan premuim yang dikutip itu untuk tujuan lain.
Dengan kata kata lain,orang ramai tidak perlu lagi bimbang untuk membeli insurans motor dengan agen bertauliah.Malah pembelian menerusi agen lebih selamat dari sudut keperluan insurans serta dari segi perkhidmatan lepas jualannya.Agen insurans berupaya menjadi tempat rujuk kepada permasalahan insurans secara bersekemuka dan mudah berbanding dengan pembelian melalui bank yang selalunya kakitangannya tidak memiliki maklumat insurans yang cukup berbanding agen yang insya Allah boleh membantu dan menyelesaikan permasalahan insurans pengguna.
Dengan perlaksaan ini,cover note secara manual tidak lagi sah dan pengeluarannya dibuat melalui komputer dan internet.Perlaksanaan e INSURANS ini juga menandakan berakhirnya segala penipuan insurans yang sebelum ini banyak dilapurkan.Agen agen insurans tidak lagi mengeluarkan cover note sewang wenangnya sebaliknya sebarang cover note yang dikeluarkan akan mudah dipantau oleh prinsipal.Perlaksanaan ini juga memudah dan mempercepatkan urusan pembaharuan road tax.
Selain dari itu perlaksanaan e INSURANS juga menjamin bayaran premium sampai kepada prinsipal tepat pada waktunya.Agen tidak lagi mempunyai ruang untuk menggunakan premuim yang dikutip itu untuk tujuan lain.
Dengan kata kata lain,orang ramai tidak perlu lagi bimbang untuk membeli insurans motor dengan agen bertauliah.Malah pembelian menerusi agen lebih selamat dari sudut keperluan insurans serta dari segi perkhidmatan lepas jualannya.Agen insurans berupaya menjadi tempat rujuk kepada permasalahan insurans secara bersekemuka dan mudah berbanding dengan pembelian melalui bank yang selalunya kakitangannya tidak memiliki maklumat insurans yang cukup berbanding agen yang insya Allah boleh membantu dan menyelesaikan permasalahan insurans pengguna.
Isnin, 28 Julai 2008
TIPS ON BUYING THE RIGHT MOTOR INSURANCE POLICY
Source: www.thestar.com.my
IN the event of a minor road accident, the first thing drivers tend to do is to get out of their cars and start playing the 'blame game'. It doesn't matter if the accident was clearly caused by one party, everyone involved will insist that they are free of blame for fear of losing their no-claim-discount (NCD).
"Owners who enjoy tinkering with their car engines and modifying the power or performance need to disclose this information to the insurance company"
But there are more honest and less stressful ways of handling an accident, and the first thing to do is to be an informed driver.While it is not possible to diminish the damages to your vehicle once the accident has occurred, it is possible to curtail the damage to your finances. It all depends on the motor insurance policy that was purchased.Unfortunately, many drivers do not take the time to understand their policy or the related jargon such as "average clause" and "disclosure" until they are frantically trying to make a claim after an accident.Drivers should bear in mind that there are a number of details that should be taken into account when applying for a motor insurance policy.Firstly, as soon as a car is purchased the owner must buy an insurance cover. If a used car is purchased, the new owner needs to know that the cover of the previous owner is null and void. This is true even if legal ownership transfer has not yet occurred at the Road Transport Department (RTD).The insured value - or sum insured - depends on the market value of a vehicle. Under-insurance or over-insurance can occur when this value is not determined properly.If the sum insured is less than the market value (under-insurance) the owner will only be partially compensated. If the sum insured is higher (over-insurance) the insurance company will only pay out the market value.The average clause comes into play when a damaged car has been under-insured. The owner's insurance claim can sometimes be drastically reduced because the claim will be reduced proportionately to the amount that is uninsured.Owners who enjoy tinkering with their car engines and modifying the power or performance need to disclose this information to the insurance company. Failure to provide material facts about the car, including previous accidents, can result in the insurance company refusing any claims made. If this happens, the owner will be liable.There is a 'reward' for the driver who has somehow managed to maintain an accident-free car. This is known as the no-claim-discount (NCD).The premium for the insurance will be reduced if no claim is made against the policy during the preceding 12 months. NCD entitlements depend on the class of the vehicle and the number of years of continuous driving experience without any claims made against the policy.Premium payments have been modernised since the advent of the JPJ eINSURANS system, which came into effect in January 2005. Physical cover notes are now a thing of the past and the insurance company provides all information to the RTD online. However, policy details in the form of a statement will be issued to the vehicle owner once the policy is purchased through cash, credit card or cheque.Premiums must be paid to an agent representing the insurance company or directly to the company. The insurance company is required to issue the policy within one month and vehicle owners are advised to contact the company if they have not received their policy after 30 days.
IN the event of a minor road accident, the first thing drivers tend to do is to get out of their cars and start playing the 'blame game'. It doesn't matter if the accident was clearly caused by one party, everyone involved will insist that they are free of blame for fear of losing their no-claim-discount (NCD).
"Owners who enjoy tinkering with their car engines and modifying the power or performance need to disclose this information to the insurance company"
But there are more honest and less stressful ways of handling an accident, and the first thing to do is to be an informed driver.While it is not possible to diminish the damages to your vehicle once the accident has occurred, it is possible to curtail the damage to your finances. It all depends on the motor insurance policy that was purchased.Unfortunately, many drivers do not take the time to understand their policy or the related jargon such as "average clause" and "disclosure" until they are frantically trying to make a claim after an accident.Drivers should bear in mind that there are a number of details that should be taken into account when applying for a motor insurance policy.Firstly, as soon as a car is purchased the owner must buy an insurance cover. If a used car is purchased, the new owner needs to know that the cover of the previous owner is null and void. This is true even if legal ownership transfer has not yet occurred at the Road Transport Department (RTD).The insured value - or sum insured - depends on the market value of a vehicle. Under-insurance or over-insurance can occur when this value is not determined properly.If the sum insured is less than the market value (under-insurance) the owner will only be partially compensated. If the sum insured is higher (over-insurance) the insurance company will only pay out the market value.The average clause comes into play when a damaged car has been under-insured. The owner's insurance claim can sometimes be drastically reduced because the claim will be reduced proportionately to the amount that is uninsured.Owners who enjoy tinkering with their car engines and modifying the power or performance need to disclose this information to the insurance company. Failure to provide material facts about the car, including previous accidents, can result in the insurance company refusing any claims made. If this happens, the owner will be liable.There is a 'reward' for the driver who has somehow managed to maintain an accident-free car. This is known as the no-claim-discount (NCD).The premium for the insurance will be reduced if no claim is made against the policy during the preceding 12 months. NCD entitlements depend on the class of the vehicle and the number of years of continuous driving experience without any claims made against the policy.Premium payments have been modernised since the advent of the JPJ eINSURANS system, which came into effect in January 2005. Physical cover notes are now a thing of the past and the insurance company provides all information to the RTD online. However, policy details in the form of a statement will be issued to the vehicle owner once the policy is purchased through cash, credit card or cheque.Premiums must be paid to an agent representing the insurance company or directly to the company. The insurance company is required to issue the policy within one month and vehicle owners are advised to contact the company if they have not received their policy after 30 days.
INSURANS DAN KEPENGGUNAAN
Assalamualaikum,
Insurans adalah keperluan kehidupan.insuran merupakan langkah perlindungan bagi mengurangkan risiko kerugian.Dalam banyak hal,kerugian yang ditanggung akibat sesuatu kejadian luar jangka seperti kemalangan tidak akan dilindungan tanpa perlindungan insurans.Jadi insuran pada dasarnya ialah penggantian kepada sebarang kerugian yang ditanggung apabila kejadian diluar jangka seperti kemalangan berlaku.
Umumnya insurans di negara kita dikawal selia oleh akta insurans 1965 di mana bank negara diberi kuasa mengawal aktiviti penjualan polisi insurans.Di pihak pengguna mereka dilindungi sepenuhnya dengan polis iunsuran yang dibeli tertakluk kepada klaus klaus tertentu yang tercatit dalam polisi tersebut.Oleh itu adalah perlu bagi seorang pengguna insuran mengetahui isi polisi insurans yang dibeli.
Pada tahap ini saya ingin menjelaskan bahawa insuran terbahagi kepada 2 katogeri utama ia itu:
1. Insurans nyawa atau Insurans hayat
2.Insurans Am yang pula terbahagi kepada beberapa kelas termasuk yang utama ialah insurans kereta motor ,insurans kebakaran,insurans kemalangan dan beberapa kelas lagi yang mungkin kurang popular kepada kebanyakan pengguna kecuali kepada kelompok pengguna tertentu.
Oleh yang demikian,suka saya menumpukan kepada insurans kereta motor di mana terdapat beberapa perkara utama yang perlu diketahui oleh pengguna.Umumnya agen yang menjual insurans ialah seorang yang memiliki kebenaran dari syarikat insurans(prinsipal) dan memiliki sijil serta didaftarkan di persatuan insurans am malaysia(PIAM).Seorang agen insurans am hanya dibenarkan penjual polisi dari 2 prinsipal sahaja.
Dalam kelas insurans kereta motor,keperluan insurans pihak ketiga diwajibkan berdasarkan akta pengankutan jalan bermakna setiap kenderaan diwajibkan memilki polisi insuran pihak ketiga(3rd party) sebelum dibenarkan membaharui cukai jalan mereka.
dalam mengenalpasti keperluan insurans pula,pemilik kenderaan adalah dikehendaki membuat pertimbangan kepada risiko yang ditanggung bila memandu dan kemampuan menanggung kos pembaikan sekiranya berlaku kemalangan.Bagi kes kes di mana kerosakan dikiraboleh ditampung sendiri maka polisi pihak ketiga(3rd party) dikira memadai tetapi sekiranya kos pembaikan tidak mampu ditanggung pemilik dinasihati mengambil polisi komprehensif ia itu polisi yang mengandungi perlindungan pihak ketiga dan juga melindungi kenderaan pemilik sendiri.Dalam kes kes melibatkan pinjaman bank, umumnya bank mewajibkan polisi komprehensif.
Satu lagi aspek yang perlu diketahui oleh pemilik kenderaan ialah nilai pasaran semasa kenderaan mereka.Ini adalah kerana prinsip insuran umumnya,ini memerlukan insuran kereta motor diambil mengikut nilai pasaran semasa.Dalam hal ini satu salah faham biasa terjadi bagi kenderaan yang masih dalam tanggungan hutang bank.Selalu berlaku di mana pemilik mengambil polisi mengikut jumlah baki pinjaman mereka.Perkara ini tidak betul dan menyalahi prinsip insurans serta mungkin merugikan pemilik sekiranya berlaku kemalangan.Kemungkinan jumlah yang diinsuranskan dibawah keperluan pasaran(under insured) atau melebih harga pasara semasa(over insured).Dalam kedua dua kes pemilik di pihak yang rugi.dalam kes under insured pemilik akan di kehendaki menambah kos pembaikian sekiranya berlaku kemalangan dan dalamkes over insured,pemilik menanggung kerugian lebihan permium yang dibayar sedangkan insurans hanya akan membayar mengikut nilai pasara semasa apabila berlaku kemalangan.
Setakat ini dulu bicara insurans kita,insya Allah akan disambung lain kali.
Insurans adalah keperluan kehidupan.insuran merupakan langkah perlindungan bagi mengurangkan risiko kerugian.Dalam banyak hal,kerugian yang ditanggung akibat sesuatu kejadian luar jangka seperti kemalangan tidak akan dilindungan tanpa perlindungan insurans.Jadi insuran pada dasarnya ialah penggantian kepada sebarang kerugian yang ditanggung apabila kejadian diluar jangka seperti kemalangan berlaku.
Umumnya insurans di negara kita dikawal selia oleh akta insurans 1965 di mana bank negara diberi kuasa mengawal aktiviti penjualan polisi insurans.Di pihak pengguna mereka dilindungi sepenuhnya dengan polis iunsuran yang dibeli tertakluk kepada klaus klaus tertentu yang tercatit dalam polisi tersebut.Oleh itu adalah perlu bagi seorang pengguna insuran mengetahui isi polisi insurans yang dibeli.
Pada tahap ini saya ingin menjelaskan bahawa insuran terbahagi kepada 2 katogeri utama ia itu:
1. Insurans nyawa atau Insurans hayat
2.Insurans Am yang pula terbahagi kepada beberapa kelas termasuk yang utama ialah insurans kereta motor ,insurans kebakaran,insurans kemalangan dan beberapa kelas lagi yang mungkin kurang popular kepada kebanyakan pengguna kecuali kepada kelompok pengguna tertentu.
Oleh yang demikian,suka saya menumpukan kepada insurans kereta motor di mana terdapat beberapa perkara utama yang perlu diketahui oleh pengguna.Umumnya agen yang menjual insurans ialah seorang yang memiliki kebenaran dari syarikat insurans(prinsipal) dan memiliki sijil serta didaftarkan di persatuan insurans am malaysia(PIAM).Seorang agen insurans am hanya dibenarkan penjual polisi dari 2 prinsipal sahaja.
Dalam kelas insurans kereta motor,keperluan insurans pihak ketiga diwajibkan berdasarkan akta pengankutan jalan bermakna setiap kenderaan diwajibkan memilki polisi insuran pihak ketiga(3rd party) sebelum dibenarkan membaharui cukai jalan mereka.
dalam mengenalpasti keperluan insurans pula,pemilik kenderaan adalah dikehendaki membuat pertimbangan kepada risiko yang ditanggung bila memandu dan kemampuan menanggung kos pembaikan sekiranya berlaku kemalangan.Bagi kes kes di mana kerosakan dikiraboleh ditampung sendiri maka polisi pihak ketiga(3rd party) dikira memadai tetapi sekiranya kos pembaikan tidak mampu ditanggung pemilik dinasihati mengambil polisi komprehensif ia itu polisi yang mengandungi perlindungan pihak ketiga dan juga melindungi kenderaan pemilik sendiri.Dalam kes kes melibatkan pinjaman bank, umumnya bank mewajibkan polisi komprehensif.
Satu lagi aspek yang perlu diketahui oleh pemilik kenderaan ialah nilai pasaran semasa kenderaan mereka.Ini adalah kerana prinsip insuran umumnya,ini memerlukan insuran kereta motor diambil mengikut nilai pasaran semasa.Dalam hal ini satu salah faham biasa terjadi bagi kenderaan yang masih dalam tanggungan hutang bank.Selalu berlaku di mana pemilik mengambil polisi mengikut jumlah baki pinjaman mereka.Perkara ini tidak betul dan menyalahi prinsip insurans serta mungkin merugikan pemilik sekiranya berlaku kemalangan.Kemungkinan jumlah yang diinsuranskan dibawah keperluan pasaran(under insured) atau melebih harga pasara semasa(over insured).Dalam kedua dua kes pemilik di pihak yang rugi.dalam kes under insured pemilik akan di kehendaki menambah kos pembaikian sekiranya berlaku kemalangan dan dalamkes over insured,pemilik menanggung kerugian lebihan permium yang dibayar sedangkan insurans hanya akan membayar mengikut nilai pasara semasa apabila berlaku kemalangan.
Setakat ini dulu bicara insurans kita,insya Allah akan disambung lain kali.
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