How the detection of insurance fraud succeeds and fails

Abstract

Insurance fraud is a serious and growing problem, and there is widespread recognition that traditional approaches to tackling fraud are inadequate. Studies of insurance fraud have typically focused upon identifying characteristics of fraudulent claims and claimants, and this focus is apparent in the current wave of forensic and data-mining technologies for fraud detection. An alternative approach is to understand and then optimize existing practices in the detection of fraud. We report an ethnographic study that explored the nature of motor insurance fraud-detection practices in two leading insurance companies. The results of the study suggest that an occupational focus on the practices of fraud detection can complement and enhance forensic and data-mining approaches to the detection of potentially fraudulent claims.     

中国债法的现状与未来

中国债法必须完善,应当制定债法典或民法典中的债编.侵权责任法具有债法所需要的品格,应纳入债法典之中.在未来的民法典采取将合同法、侵权责任法并列设编的体系下,应当设置债法总则.中国现行债法的众多制度及规范均应完善,明确构成要件和法律效果,不宜仅有禁止性规定而无相应的法律后果.     

Transcendental institutionalism and global justice

In The Idea of Justice (2009 Sen, A. 2009. The idea of justice, Cambridge, MA: Harvard University Press. [Crossref] , [Google Scholar]), Amartya Sen distinguishes between ‘transcendental institutional’ approaches to justice and ‘realization-focused comparisons,’ rejecting the former and recommending the latter as a normative approach to global justice. I argue that Sen’s project fails for three principal reasons. First, he misdiagnoses the problem with accounts that he refers to as transcendental-institutionalist. The problem is not with these kinds of accounts per se, but with particular features of prominent approaches. Second, Sen’s realization-focus does not account well for the value of institutions of global justice. And even Sen agrees that reforms to institutions are urgently needed. And third, the distinction between transcendentalism and comparative approaches is implausible. I close by suggesting a strategy for an alternative institutionalist approach that can offer the kind of guidance for reforming the global order that Sen rightly takes as urgent.     

保险诈骗罪第4款解释路径的法律分析

片面共犯由于违背共同故意要件因而不属于共同犯罪,其不能对保险诈骗罪第4款的法律性质作出合理的解释。保险诈骗罪第4款既不属于法律拟制和注意规定,也不属于想象竞合和法规竞合,其是法律文本主义的当然解释,亦是大竞合理论下,适用从一重处断原则的当然结果。     

论以无权处分财产出资行为的法律效力

关于＂以无权处分财产出资＂的问题,《公司法司法解释（三）》第七条规定该问题可通过善意取得制度来解决。但是公司设立行为的性质区别于市场交易行为,公司设立过程中的投资行为并不具有明显的涉它性,而且公司设立过程中并未涉及到激烈矛盾的利益衡量问题。此外,在认定善意取得制度的善意要件时,无权处分人兼有＂双重身份＂,这为善意取得制度的适用带来困境。因此,不宜用善意取得制度解决无权处分财产出资设立公司的行为。     

Gender and “Other People's Money”: An Analysis of White-Collar Offender Sentencing

Although the female share of white-collar crime arrests (e.g., fraud, forgery, and embezzlement) continues to increase, little is known about the nature of women's involvement in these offenses, or the extent to which the legal treatment of white-collar offenders differs by gender. Using national survey data on employee crime, the present research addresses these voids in the literature. Consistent with prior research, women's roles in fraud offending are restricted by their positions in the organizational hierarchy. In support of the focal concerns perspective, results show that the decision to incarcerate and length of sentence are primarily shaped by indicators of offender blameworthiness. Findings reported here contribute to the literature on gender and white-collar crime, and also extend the growing body of focal concerns research to a previously unexplored sentencing context.     

Does electoral fraud spread? The expansion of electoral manipulation in Russia

In this paper, we argue that the occurrence of electoral manipulation in Russia has been driven, in part, by diffusion across neighboring raions through emulation, incentives, and networks. Presumably, in Putin’s Russia all local authorities have some incentives to deliver a high number of votes to United Russia, the “party of power”. However, the perceived pressure to deliver ever higher levels of support for Putin’s party arguably increases considerably if one’s raion is located in a region marked by extraordinarily high turnout and high vote share for United Russia. Conversely, the absence of perceived competition to curry executive favor through delivering votes and networks of uncorrupted local authorities, as well as local opposition organizations working to combat electoral fraud, may help explain the absence of fraud among raions located in regions marked by clean elections. Our quantitative analyses suggest that a “neighborhood effect” – the existence of manipulated raions within a region – strongly influences the likelihood that raions are manipulated. Moreover, although results are more mixed, spatial autocorrelation analysis suggests that turnout levels in raions are influenced by the turnout in proximate raions.     

电信诈骗打防对策探究

随着我国金融业、通信业的快速发展,电信诈骗作为一种跨境、跨地域新型团伙犯罪,借助于网络与通信工具实施非接触式虚假信息诈骗犯罪,其发展趋势迅速蔓延。公安机关应进一步探索和研究侦破此类犯罪的打防对策,从根本上遏止电信诈骗违法犯罪的高发态势。     

保险诈骗犯罪手法分析及防范策略研究

近年来,保险诈骗案件呈多发态势,扰乱了正常的保险经营秩序,阻碍了中国保险业的健康发展。研究保险诈骗犯罪及防范策略,对加强预防保险欺诈行为、维护正常的保险秩序有着重要意义。防范保险诈骗可采取以下措施:(一)保险公司自身应强化管理,提高诈骗风险控制能力;(二)保险行业内部应相互配合,搭建业内信息共享平台;(三)金融检察部门要惩防并举,加强对保险行业的保护;(四)执法部门之间需加强协作,构建线索移送通报制度;(五)公众法制宣传要点面结合,加强骗保犯罪预防效果。