Zavarovalniške goljufije v Sloveniji in izbranih državah EU

• Main Author: Pliberšek, Saša
• Other Authors: Jagrič, Vita
• Format: Bachelor Thesis
• Language: Slovenian
• Published: S. Pliberšek 2018
• Subjects: zavarovanje; zavarovalnica; zavarovanec; zavarovalniška goljufija; finančni kriminal; gospodarska kriminaliteta; protipravno premoženje; insurance; insurance company; insurer; insurance fraud; financial crime; illegal monetary benefit; info:eu-repo/classification/udc/368; sami
• Online Access: https://dk.um.si/IzpisGradiva.php?id=71884; https://dk.um.si/Dokument.php?id=130299&dn=; https://plus.si.cobiss.net/opac7/bib/13191196?lang=sl

Goljufije v zavarovalništvu obstajajo že, odkar obstaja zavarovalništvo samo, storilci pa pri njihovem izvajanju vsakič znova kažejo svojo iznajdljivost. Zavarovalniške goljufije se uvrščajo med finančni kriminal, ki je ena izmed podzvrsti gospodarskega kriminala. Pojavljajo se pri različnih segmentih zavarovanj, številčno pa prednjačijo predvsem tiste pri avtomobilskih zavarovanjih Ocenjuje se, da je pri nekaterih vrstah zavarovanj vsaj eden izmed desetih odškodninskih zahtevkov goljufiv, kar vodi v višanje premij na svetovni ravni. Kljub ukrepom za njihovo zatiranje, so zavarovalniške goljufije še vedno precej razširjene, tako pri nas, kot v svetu. Dejstvo je, da bodo vedno obstajali posamezniki, ki se bodo želeli okoristiti na račun drugih in jim s svojimi protipravnimi in kaznivimi dejanji povzročali škodo, da bi sami od tega imeli korist, predvsem v finančnem smislu. Glavni cilj goljufov je zavesti zavarovalnico z namenom pridobitve odškodninskega izplačila ali druge protipravne koristi. Škodo in s tem velike izgube povzročajo tako zavarovalnicam, gospodarstvu, kot poštenim zavarovancem. Stroški, povezani z lažnimi zahtevki in s preiskovanjem ter obvladovanjem goljufij, se v splošnem prenesejo na vse zavarovance na način, da zavarovalnice zvišujejo zavarovalne premije sočasno z zviševanjem cen produktov in storitev. Pri boju zoper goljufijam in s tem zavzemanje za zmanjšanje stroškov, je za zavarovalnice pomembno medsebojno sodelovanje (izmenjava ključnih informacij), kot tudi sodelovanje z državnimi organi pregona (policija, sodstvo.), hkrati pa o tej problematiki in njenih posledicah osveščati javnost. S skupnimi močmi lahko oblikujejo učinkovitejše ukrepe in strategije za preiskovanje in zatiranje perečega problema. Zavedati se je namreč potrebno, da pri zavarovalništvu že majhna laž lahko vodi do enormnih posledic, za goljufijami pa se lahko skrivajo še hujša kazniva dejanja. Insurance frauds exist since the very beginin of insurance. Fraudsters show their flexibility and inventiveness with every new act of fraud they make. Insurance frauds are classified as financial crime, which is a subtype of economic crime. They exist in all sectors of insurance but in most cases, perpetrating frauds are committed in car insurance sector. It is estimated that in some retail categories one in 10 claims is related to fraud. Despite the insurance industry's actions to reduce frauds, they are still very common in our country as well as on the world scale. It is the fact of life that there will always be individuals who will seek opportunities to benefit themselves by committing illigal and criminal acts. The main goal for insurance fraudsters is to deceive the insurance company in order to gain compensation or other undeserved monetary benefits. They are causing large costs and losses to the insurers, the honest policyholders and the whole economy. The costs associated with false claims and fighting fraud are in general passed to honest insurants. Insurance companies are increasing costs of their products and services, which leads to increased insurance premiums. Dealing with frauds and cost reduction it is important for insurance companies to work together (sharing of crucial information), to collaborate with law enforcement agencies (police, judiciary.) and to keep general public informed about this wide-ranging problem and it's consequences. By working together, they can be much more effective in fighting fraud and develop new effective preventive and repressive strategies. When it comes to insurance, any type of falsehood, whether it's a little white lie or an outright lie, can carry heavy consequences and oftentimes, a fraud in the process of investigation can uncover other acts of serious criminal activity as well.