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The relationship between moral hazard and insurance fraud

Author

Listed:
  • Mahito Okura

Abstract

Purpose - The purpose of this paper is to investigate the insurance market in which moral hazard and insurance fraud coexist. In this situation, this research examines the relationship between moral hazard and insurance fraud. Also, this research shows how the amount of policyholder's effort to lower accident probability changes when insurance firm increases their investment in preventing insurance fraud. Design/methodology/approach - Using a theoretical model containing five-stages, the author sheds light on how the possibility of insurance fraud affects the amount of policyholder's effort. Findings - The main results of this research are as follows. First, the amount of policyholder's effort is a weakly monotone decreasing function of the insurance firm's investment in preventing insurance fraud. Second, unlike in previous moral hazard models, the policyholder chooses a strictly positive amount of effort even in the full insurance case because the possibility of insurance fraud gives an incentive to realize policyholder's effort. Third, the amount of insurance firm's investment in preventing insurance fraud depends on whether it wants to give an additional incentive to policyholder's effort in exchange for realizing the possibility of insurance fraud. Originality/value - This is the first paper to investigate the relationship between moral hazard and insurance fraud by using the microeconomic theory.

Suggested Citation

  • Mahito Okura, 2013. "The relationship between moral hazard and insurance fraud," Journal of Risk Finance, Emerald Group Publishing, vol. 14(2), pages 120-128, February.
  • Handle: RePEc:eme:jrfpps:v:14:y:2013:i:2:p:120-128
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    References listed on IDEAS

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    1. M. Martin Boyer, 2007. "Resistance (to Fraud) Is Futile," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 74(2), pages 461-492.
    2. Georges Dionne & Florence Giuliano & Pierre Picard, 2009. "Optimal Auditing with Scoring: Theory and Application to Insurance Fraud," Management Science, INFORMS, vol. 55(1), pages 58-70, January.
    3. Holmstrom, Bengt & Milgrom, Paul, 1991. "Multitask Principal-Agent Analyses: Incentive Contracts, Asset Ownership, and Job Design," Journal of Law, Economics, and Organization, Oxford University Press, vol. 7(0), pages 24-52, Special I.
    4. David Rowell & Luke B. Connelly, 2012. "A History of the Term “Moral Hazard”," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 79(4), pages 1051-1075, December.
    5. Steven Shavell, 1979. "Risk Sharing and Incentives in the Principal and Agent Relationship," Bell Journal of Economics, The RAND Corporation, vol. 10(1), pages 55-73, Spring.
    6. Mark V. Pauly, 1974. "Overinsurance and Public Provision of Insurance: The Roles of Moral Hazard and Adverse Selection," The Quarterly Journal of Economics, Oxford University Press, vol. 88(1), pages 44-62.
    7. Grossman, Sanford J & Hart, Oliver D, 1983. "An Analysis of the Principal-Agent Problem," Econometrica, Econometric Society, vol. 51(1), pages 7-45, January.
    8. Holmstrom, Bengt & Milgrom, Paul, 1987. "Aggregation and Linearity in the Provision of Intertemporal Incentives," Econometrica, Econometric Society, vol. 55(2), pages 303-328, March.
    9. Picard, Pierre, 1996. "Auditing claims in the insurance market with fraud: The credibility issue," Journal of Public Economics, Elsevier, vol. 63(1), pages 27-56, December.
    10. Steven Shavell, 1979. "On Moral Hazard and Insurance," The Quarterly Journal of Economics, Oxford University Press, vol. 93(4), pages 541-562.
    11. Bengt Holmstrom, 1979. "Moral Hazard and Observability," Bell Journal of Economics, The RAND Corporation, vol. 10(1), pages 74-91, Spring.
    12. Kojima Koji & Okura Mahito, 2008. "Effort Allocation of Insurance Agent under Asymmetric Information: An Analytical Approach," Asia-Pacific Journal of Risk and Insurance, De Gruyter, vol. 2(2), pages 1-20, March.
    13. Boyer, M Martin, 2000. " Insurance Taxation and Insurance Fraud," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 2(1), pages 101-134.
    14. M. Martin Boyer, 2000. "Centralizing Insurance Fraud Investigation*," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 25(2), pages 159-178, December.
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    Cited by:

    1. Carlos Guiné, 2014. "Global Systemically Important Insurers," EIOPA Financial Stability Report - Thematic Articles 2, EIOPA, Risks and Financial Stability Department.
    2. Sabau-Popa Claudia Diana & Bradea Ioana & Bolos Marcel Ioan & Delcea Camelia, 2015. "The Information Confidentiality And Cyber Security In Medical Institutions," Annals of Faculty of Economics, University of Oradea, Faculty of Economics, vol. 1(1), pages 855-864, July.

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