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Erklärungsansätze für vertragswidriges Verhalten von Versicherungsnehmern aus Sicht der ökonomischen Theorie

  • Nell, Martin
  • Schiller, Jörg
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    Ziel dieser Arbeit ist es, in die ökonomische Analyse des Versicherungsbetrugs einzuführen und einige grundlegende Determinanten für vertragswidriges Verhalten von Versicherungsnehmern aufzuzeigen. Dazu werden zunächst die strategischen Entscheidungsprobleme von Versicherungsnehmern und Versicherern eingehend analysiert und optimales Verhalten unter realitätsnahen Annahmen hergeleitet, sowie Ansatzpunkte für die Betrugsbekämpfung aufgezeigt. Beispielhaft werden dazu die Auswirkungen von Betrugserkennungssystemen oder die konsequente Anzeige entdeckter Betrüger auf die Bekämpfung von Versicherungsbetrug näher untersucht. Es zeigt sich, dass beide Ansatzpunkte erheblichen Einfluss auf die Kosten des Versicherungsbetrugs haben können. Ein häufig geäußerter Kritikpunkt an solchen Analysen ist, dass ethische Bedenken der Versicherungsnehmer meist unberücksichtigt bleiben. Die Einbeziehung von ethischen Bedenken führt aber nicht zwangsläufig zu einer niedrigeren Betrugshäufigkeit. Abschließend wird der Frage nachgegangen, inwieweit Versicherungsbetrug auf versicherungsspezifische Faktoren zurückzuführen ist und wie bzw. in welchem Umfang Versicherer Einfluss auf die ethische Bewertung des Versicherungsbetrugs durch Versicherungsnehmer nehmen können.

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    Paper provided by University of Hamburg, Institute for Risk and Insurance in its series Working Papers on Risk and Insurance with number 7.

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    Date of creation: 2002
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    Handle: RePEc:zbw:hzvwps:7
    Contact details of provider: Web page: http://www.hzv-uhh.de/

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    1. Fehr, Ernst & Schmidt, Klaus M., 1999. "A theory of fairness, competition, and cooperation," Munich Reprints in Economics 20650, University of Munich, Department of Economics.
    2. Ching-to Albert Ma & Ingela Alger, 1999. "Moral Hazard, Insurance and Some Collusion," FMG Discussion Papers dp318, Financial Markets Group.
    3. Marie-Cécile Fagart & Pierre Picard, 1999. "Optimal Insurance Under Random Auditing," The Geneva Risk and Insurance Review, Palgrave Macmillan, vol. 24(1), pages 29-54, June.
    4. Kai Sülzle & Achim Wambach, 2005. "Insurance in a Market for Credence Goods," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 72(1), pages 159-176.
    5. Robert Townsend, 1979. "Optimal contracts and competitive markets with costly state verification," Staff Report 45, Federal Reserve Bank of Minneapolis.
    6. 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.
    7. Mookherjee, Dilip & Png, Ivan, 1989. "Optimal Auditing, Insurance, and Redistribution," The Quarterly Journal of Economics, MIT Press, vol. 104(2), pages 399-415, May.
    8. Fahad Khalil, 1997. "Auditing Without Commitment," RAND Journal of Economics, The RAND Corporation, vol. 28(4), pages 629-640, Winter.
    9. M. Martin Boyer, 2000. "Centralizing Insurance Fraud Investigation*," The Geneva Risk and Insurance Review, Palgrave Macmillan, vol. 25(2), pages 159-178, December.
    10. 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.
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