aditi lanka, security services, vip bodyguard services, sri lanka
aditi lanka, security services, vip bodyguard services, sri lanka
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Aditi lanka

Aditi Securing Your Future

Investigation Analysis For Insurance Companies

Insurance fraud is a deliberate deception perpetrated against or by an insurance company or agent for the purpose of financial gain. Fraud may be committed at different points in the transaction by applicants, policyholders, third-party claimants, or professionals who provide services to claimants. Insurance agents and company employees may also commit insurance fraud. Common frauds include “padding,” or inflating claims; misrepresenting facts on an insurance application; submitting claims for injuries or damage that never occurred; and staging accidents.

People who commit insurance fraud include organized criminals who steal large sums through fraudulent business activities, professionals and technicians who inflate service costs or charge for services not rendered, and ordinary people who want to cover their deductible or view filing a claim as an opportunity to make a little money. Some lines of insurance are more vulnerable to fraud than others. Healthcare, workers’ compensation and auto insurance are generally considered the sectors most affected.


Public Attitudes Toward Fraud

Aditi Lanka conducted a rigorous and extensive research process in insurance frauds and revealed that the attitude of the public has hampered insurers’ fight against fraud. Studies suggest that some portion of insurance fraud committed by customers is driven by revenge or retaliation for a personal service exchange that they think is unfair. People may retaliate to “get a return” or “get their money’s worth.”


Auto Insurance Fraud

Auto insurance fraud ranges from misrepresenting facts on insurance applications and inflating insurance claims to staging accidents and submitting claim forms for injuries or damages that never occurred. Fraud accounted for between 15percent and 17percent of total claims payments for auto insurance bodily injury in 2012, according to an Insurance Research Council (IRC) study. This trend is progressively rising and the newest details could not be extracted due to the lack of resources in Sri Lanka and due to the Covid 19 Pandemic restrictions. Auto insurance is a system that allows policyholders to recover financial losses from their own insurance company, regardless of who was at fault in a motor vehicle accident. Salvage fraud is another common auto fraud that involves vehicles damaged by natural disasters including flooding that later appear in used car lots and vehicle sales. Unscrupulous sellers may switch or clone manufacturers’ serial number plates and put them on another vehicle that has been repaired.


Healthcare Fraud

Although healthcare insurance is generally outside the purview of property/casualty insurance, healthcare fraud affects all types of property/casualty insurance coverage that include a medical care component, such as medical payments for auto accident victims or workers injured in the workplace. Fraud and abuse take place at many points in the healthcare system. Doctors, hospitals, nursing homes, diagnostic facilities, medical equipment suppliers, and attorneys have been cited in scams to defraud the system. The National Health Care Anti-Fraud Association (NHCAA) in the USA estimates that the financial losses due to health care fraud are in the tens of billions of dollars each year. We often experience that the policyholders are admitting to the hospitals for no reason as the bills are being covered by the insurance policy.


Workers Compensation Fraud

Employers who misrepresent their payroll or the type of work carried out by their workers to pay lower premiums are committing workers’ compensation fraud. Some employers also apply for coverage under different names to foil attempts to recover money owed on previous policies or to avoid detection of their poor claim record.


Catastrophe-Related Property Fraud

When disasters strike some individuals or groups see an opportunity to file claims that are either exaggerated or completely false. Some even intentionally damage property after a disaster to receive a higher payout.


Insurers’ Antifraud Measures

The legal options of an insurance company that suspects fraud is limited. An insurer can inform a private investigating agency of suspicious claims, withhold payment, and collect evidence for use in court. The success of the battle against insurance fraud, therefore, depends on two elements, the level of priority assigned by legislators, regulators, law enforcement agencies, and society and the resources devoted by the insurance industry itself Insurers may file civil lawsuits, which require that insurers provide a preponderance of the evidence, rather than the stricter rules of evidence required in criminal actions. It also allows for triple damages. From the late 1990s on, some of the largest insurers in the country, especially auto insurers have been filing lawsuits concerning insurance fraud against individuals and organized rings.

Most insurers have established special investigation units (SIUs) to help identify and investigate suspicious claims. However, those agencies are comprised of retired law enforcement officials and employees that have not been properly trained, because of the unprofessionalism of these units the insurance companies are losing their cases. Highlighting below is a sketch that Aditi Lanka is preparing in investigating a scenario. However, this process is a rigorous and dedicated professional task that only Aditi Lanka can deliver in Sri Lanka.

To successfully bring a fraud case to trial, insurers must be able to provide information to prosecutors on individuals suspected of fraud. Immunity laws, which allow insurance companies to report information without fear of criminal or civil prosecution, now exist in all countries. However, not all laws cover insurance fraud specifically, nor do all regulations allow information to be reported to law enforcement agencies or insurance ombudsmen. Many are limited in other ways, like only protecting libel suits or violation of unfair claims practices in auto insurance fraud.


How Does Aditi Lanka Will Make the Difference?

Aditi is a security solution provider; Aditi has National and International level collaborating companies who are much superior in technology and training. They will visit the site to collect evidence including audio, visual, and secondary evidence of the scene. They will finalise the crash or accident documentation including a crash site map with all available shreds of evidence. The whole process will be executed in a scientific method.


What Is an Accident Reconstruction Drawing?

Accident reconstruction drawings are visual recreations or sketches of an accident. They normally depict the accident and the surrounding area, as well as the vehicles and people involved. They’re created using eyewitness reports, photos, security footage, and physical evidence.


Why Sketching a Vehicle Accident Is Important?

Accident reconstruction drawings are visual recreations or sketches of an accident. They normally depict the accident and the surrounding area, as well as the vehicles and people involved. They’re created using eyewitness reports, photos, security footage, and physical evidence.


How to Prepare an Accident Reconstruction

Start by setting the scene. We begin with a satellite image of the accident scene from Google Earth. This will allow us to develop your accident reconstruction with an accurate setting.



How Can Aditi Help?

We will visit the scene on request, we will collect all evidence. Collect primary and secondary data. Visit third parties involved. Will visit government officials and offices and collect evidence. We will start with an
accident reconstruction template. This is much easier and more accurate than trying to elaborate the scenario verbally. In addition, when we are finished, the insurance company will have a presentation-quality graphic. Aditi can elaborate its potential in an audience with your company in due course.

We do scientific research, investigation, and extract the truth out from a complex irresolute event that happened before. Aditi Lanka experts have been trained in foreign best Accident Investigation Schools and were employed as subject matter experts in Sri Lanka Armed forces. They have conducted many investigations and have 22 years of subject matter experience as accident and safety investigators.


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