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Fraudulent Claims and Nitpicky Insurers

  • Jean-Marc Bourgeon

    (Institut National de la Recherche Agronomique - INRA, Department of Economics, Ecole Polytechnique - CNRS : UMR7176 - Polytechnique - X)

  • Pierre Picard

    (Department of Economics, Ecole Polytechnique - CNRS : UMR7176 - Polytechnique - X)

Insurance fraud is a major source of inefficiency in insurance markets. A self-justification of fraudulent behavior is that insurers are bad payers who start nitpicking if an opportunity arises, even in circum- stances where the good-faith of policyholders is not in dispute. We relate this nitpicking activity to the inability of insurers to commit to their auditing strategy. Reducing the indemnity payments acts as an incentive device for the insurer since auditing is profitable even if the claim is not fraudulent. We show that optimal indemnity cuts are bounded above and that nitpicking remains optimal even if it induces adverse effects on policyholders' moral standards.

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Paper provided by HAL in its series Working Papers with number hal-00675106.

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Date of creation: 29 Feb 2012
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Handle: RePEc:hal:wpaper:hal-00675106
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  1. 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.
  2. Xavier Gabaix & David Laibson, 2006. "Shrouded Attributes, Consumer Myopia, and Information Suppression in Competitive Markets," The Quarterly Journal of Economics, MIT Press, vol. 121(2), pages 505-540, May.
  3. Georges Dionne & Robert Gagné, 2001. "Deductible Contracts Against Fraudulent Claims: Evidence From Automobile Insurance," The Review of Economics and Statistics, MIT Press, vol. 83(2), pages 290-301, May.
  4. Strutton, David & Vitell, Scott J. & Pelton, Lou E., 1994. "How consumers may justify inappropriate behavior in market settings: An application on the techniques of neutralization," Journal of Business Research, Elsevier, vol. 30(3), pages 253-260, July.
  5. Tennyson, Sharon, 1997. "Economic institutions and individual ethics: A study of consumer attitudes toward insurance fraud," Journal of Economic Behavior & Organization, Elsevier, vol. 32(2), pages 247-265, February.
  6. Picard, Pierre, 1994. "Auditing claims in insurance market with fraud : the credibility issue," CEPREMAP Working Papers (Couverture Orange) 9420, CEPREMAP.
  7. M. Martin Boyer, 2004. "Overcompensation as a Partial Solution to Commitment and Renegotiation Problems: The Case of "Ex Post" Moral Hazard," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 71(4), pages 559-582.
  8. Michal Krawczyk, 2009. "The Role of Repetition and Observability in Deterring Insurance Fraud," The Geneva Risk and Insurance Review, Palgrave Macmillan, vol. 34(1), pages 74-87, June.
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