diplomsko delo univerzitetnega študija
Anže Zupančič (Author), Danijela Frangež (Mentor), Anton Dvoršek (Co-mentor)

Abstract

V diplomski nalogi predstavljamo postopke in načine preprečevanja, odkrivanja in preiskovanja zavarovalniških goljufij. Obstaja več različnih vrst zavarovalniških goljufij. V nalogi smo se osredotočili na goljufive odškodninske zahtevke zavarovancev. Statistika kaže, da so goljufije v porastu, in zaradi njih imajo zavarovalnice visoke izgube. Goljufi delujejo predvsem takrat, ko se jim ponudi priložnost. Za učinkovito omejevanje goljufij je treba vzpostaviti ustrezno strategijo, prek katere se skladno izvajajo aktivnosti preprečevanja, odkrivanja in preiskovanja goljufij. Ugotovili smo, da se je z uporabo računalniških orodij učinkovitost odkrivanja in preiskovanja goljufij povečala. Ena izmed ključnih ugotovitev je, da je za uspešno omejevanje goljufij neizogibno sodelovanje analitikov zavarovalnice in njihovih zunanjih sodelavcev. Za zmanjšanje števila goljufij lahko veliko storimo že v procesu preprečevanja, med drugim z aktivnostmi odvračanja potencialnih goljufov. Ugotovili smo, da dve temeljni mednarodni organizaciji postavljata sodobne okvire za učinkovito omejevanje goljufij, in po njiju se zgledujejo tudi v Zavarovalnici Triglav. V zadnjih letih je bil na področju zavarovalniških goljufij storjen velik napredek. Vzpostavitev preiskovalnih enot znotraj zavarovalnic omogoča pravočasen odgovor storilcem goljufij in ustrezno sankcioniranje. V nalogi predstavljamo vrste goljufij in posledice, ki jih občutimo praktično vsi. Glavna tema diplomske naloge je predstavitev Službe za preprečevanje, odkrivanje in preiskovanje prevar Zavarovalnice Triglav ter njenega vpliva na obvladovanje zavarovalniških goljufij. S praktičnim primerom ponazarjamo dejanski potek odkrivanja in preiskovanja zavarovalniških goljufij.

Keywords

zavarovalništvo;zavarovalnice;goljufije;odkrivanje;preiskovanje;preprečevanje;diplomske naloge;

Data

Language: Slovenian
Year of publishing:
Typology: 2.11 - Undergraduate Thesis
Organization: UM FVV - Faculty of Criminal Justice
Publisher: A. Zupančič]
UDC: 343.98:343.72(043.2)
COBISS: 2863082 Link will open in a new window
Views: 1451
Downloads: 263
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Other data

Secondary language: English
Secondary abstract: In our thesis we present procedures and ways of insurance fraud prevention, detection and investigation. There are many different kinds of insurance fraud. We focused on claims fraud. Statistics show that fraud is increasing, and for this reason insurance companies are meeting big losses. Fraudsters are active especially when they get the opportunity. For effective fraud limitation it is necessary to establish appropriate strategy, through which activities of prevention, detection and investigation of insurance fraud are performed. We found out, that effectiveness of detection and investigation has increased by using computer tools. One of the key findings is that cooperation between analysts and their external collaborators is inevitable in order to successfully limitate fraud. For reducing the number of fraud it can be already done a lot in the prevention process, among other things by deterrence of potential fraudsters. We also found out that there are two basic international organisations, which are raising modern frames for effective fraud limitation. The Triglav Insurance Company also follows the trend of those organisations. In the last couple of years there was great progress made in the field of insurance fraud. Establishing investigative units inside insurance companies enables timely answers to fraudsters and suitable sanctions. In our thesis we present all kinds of insurance fraud and their consequences, which affect everyone. The main subject of the thesis is to present the effect of Service for insurance fraud prevention, detection and investigation in the Triglav Insurance Company on controlling the fraud. We also illustrate actual course of insurance fraud detection and investigation by practical example.
URN: URN:SI:UM:
Type (COBISS): Bachelor thesis/paper
Thesis comment: Univ. v Mariboru, Fak. za varnostne vede, Ljubljana
Pages: 50 str.
ID: 8730002