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Title:Zavarovalniške goljufije na področju zavarovanja splošne odgovornosti : diplomsko delo univerzitetnega študija
Authors:ID Savković, Uroš (Author)
ID Eman, Katja (Mentor) More about this mentor... New window
Files:.pdf UN_Savkovic_Uros_2016.pdf (14,46 MB)
MD5: 8FF97F5632CB6704A8BDB85CD0D6AA09
 
Language:Slovenian
Work type:Undergraduate thesis
Typology:2.11 - Undergraduate Thesis
Organization:FVV - Faculty of Criminal Justice and Security
Abstract:Zavarovalniške goljufije so družbeni pojav, ki so neločljivo povezane z obstojem zavarovalnic in so v različnih oblikah prisotne na vseh področjih zavarovanj. Predstavljajo velik problem tako v Sloveniji, kot tudi drugod po svetu in se spreminjajo skupaj z družbenimi spremembami in ukrepi, ki jih zavarovalnice uvedejo zoper zavarovalniške goljufije. Za vsakim zaposlenim, ki bdi nad goljufivimi zahtevki, stoji več deset tisoč drugih, ki iščejo priložnost za hiter zaslužek. Goljufije se močno razlikujejo glede na zavarovalno vrsto, niti ena pa ni izvzeta iz zavarovalniških goljufij. To diplomsko delo proučuje zavarovalniške goljufije le ene zavarovalne vrste, zavarovanja splošne odgovornosti, ki predstavlja delček zavarovalniškega portfelja. Je posebna vrsta, ki ščiti zavarovanca pred odškodninskimi zahtevki tretjih oseb in krije škodo, ki jim jo zavarovanec povzroči. Osredotočili smo se na škodne dogodke, v katerih so oškodovanci utrpeli nepremoženjsko škodo (telesne poškodbe). Z analiziranjem internih spisov Generali zavarovalnice d.d. Ljubljana smo preverjali stopnjo razširjenosti goljufij na omenjenem področju ter preverili, kdo jih vlaga, na kakšen način in zakaj. Analizirali smo tudi vlogo, ki jo imajo odvetniki oškodovancev pri vlaganju goljufivih zahtevkov. S pomočjo primerjalne metode zavarovalnih pogojev izbranega časovnega obdobja za zavarovanje odgovornosti smo analizirali tudi posledice zavarovalniških goljufij neobveznih zavarovanj. Ugotovili smo, da je razširjenost goljufij na tem področju izjemno visoka. Skoraj polovica vseh zahtevkov, ki jih oškodovanci naslovijo na zavarovalnico, je prirejenih, izvajajo pa jih predvsem priložnostni storilci, običajno v sodelovanju z zavarovancem. Rezultati analize internih spisov so pokazali, da je nezanemarljiv del goljufij povzročen s strani oškodovančevih odvetnikov. Ugotovili smo tudi, da goljufije na tem področju bolj kot na dvig premije, vplivajo na spremembe pogojev. Na podlagi ugotovitev menimo, da bodo zavarovalnice morale na področju zavarovanja splošne odgovornosti bodisi posvetiti večjo pozornost odkrivanju goljufivih zahtevkov bodisi poostriti zavarovalne pogoje. Predlagamo, da zavarovalnice začnejo slediti škodnemu dogajanju, pri odkrivanju goljufij pa se osredotočiti tudi na odvetnike oškodovancev.
Keywords:zavarovalništvo, zavarovanja, zavarovalniške goljufije, gospodarska kriminaliteta, primeri, diplomske naloge
Place of publishing:Ljubljana
Place of performance:Ljubljana
Publisher:[U. Savković]
Year of publishing:2016
Year of performance:2016
Number of pages:70 str., [58] str. pril.
PID:20.500.12556/DKUM-59773 New window
UDC:343.37:368(043.2)
COBISS.SI-ID:3197674 New window
NUK URN:URN:SI:UM:DK:A2O5FNSJ
Publication date in DKUM:12.10.2016
Views:1838
Downloads:290
Metadata:XML DC-XML DC-RDF
Categories:FVV
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Secondary language

Language:English
Title:INSURANCE FRAUD IN THE FIELD OF GENERAL LIABILITY INSURANCE
Abstract:Insurance fraud is a social phenomenon which is inseparable from the existence of insurance companies. It represents a major problem within the Slovenian territory as well as elsewhere in the world and is continuously changing along with the changes in society or measures imposed by insurance companies. For every insurance employee that tries to uncover fraudulent claims there are thousands of dishonest people seeking opportunity for easy money. Insurance fraud varies greatly depending on the class of business and yet no single class is excluded from it. This thesis examines insurance fraud from a very narrow section of insurance business, general liability insurance. It is a specific insurance that protects insured from most liability exposures other than motor, vessel and plane liability and covers damages caused by insured. We have focused on loss events in which claimants have suffered body injuries. By analysing internal claims of Generali zavarovalnica d.d. Ljubljana we have examined prevalence rate of insurance fraud on general liability insurance and have researched who is committing them, how and why. We have also analysed claimants' Lawyers' role in filing of the fraudulent claims. Comparative method of insurance conditions of specific period done by this thesis helped us analyse consequences that insurance fraud have on non compulsory insurance. We found vast prevalence of insurance fraud in this area. Almost half of all claims filed for insurance company are modified to the extend of becoming deceptive. Most of those claims are filed by ordinary people with a help of insured. Insurance fraud was mostly done by occasional offenders and not by career criminals. The result of the analysis of internal claims shows inconsiderable amount of fraudulent cases filed by claimant's lawers. We have also found that insurance fraud has greater impact of changes in conditions rather than increasing premium prices. Based on the findings, we believe that insurance companies will have to increase focus on insurance fraud or to tighten insurance conditions especially on general liability insurance. We suggest that insurance companies start following recent damage events and reform fraud prevention, focusing also on claimant's Lawers.
Keywords:insurance fraud, general liability insurance, claimaint's Lawers, changes of insurance conditions, occasional offenders


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