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Investigating Fraudulent Foreign Life Insurance Claims From Africa (A Guide for Claims Examiners, Investigators and Insurance Attorneys Worldwide)

TABLE OF CONTENTS

 

Introduction           

   

 

Section A: EXAMINING CLAIM

                   DOCUMENTS / CONDUCTING

                   INVESTIGATIONS IN AFRICA

 

 

1.    Knowledge of common illnesses

 

2.    Attitude of an Investigator in Africa

 

3.    Inquiries at the hospital/Investigating the

Illness or injury that caused death / Examining

Medical Certificate of Cause of Death

 

4.    Investigating the age of the policyholder

 

5.    Inquiries with the Police / Examining

Police documents

 

6.    Inquiries about sworn affidavits / Examining

sworn affidavits

 

7.    Cremation or Burial? Inquiries at the burial

Site or the crematorium

 

8.    Inquiries at the Civil or Deaths Registry /

Examining the Death Certificate

 

9.    What proves a death claim from Africa?

 

 

 

 

Section B: NATURE OF FRAUDULENT

                   CLAIMS

 

 

10. Nature of fraudulent claims

 

11. Fraudulent creation of claims

 

12. Insured or policyholder does not exist

 

13. Documents do not support alleged death

 

14. Body substitution

 

15. Concealment of material information in order

to receive coverage

 

16. Misrepresentation of material information

      to receive higher payments

 

17. Fraud perpetrated in connivance with

Insurance Agents

 

 

Section C: LESSONS FROM INVESTIGATIVE

                   REPORTS / CASE STUDIES

 

 

18. Empty coffin buried to defraud an

European insurer of US$500,000.00!

Nigeria / United Kingdom

 

19. Physician recants, never saw the corpse!

Togo / Canada

 

20. U.S. Army veteran declared dead by wife for

US$900,000.00!

South Africa / United States

 

21. Policyholder’s name not in the passengers’ manifest!

Uganda / United States

 

22. No corpse, yet grave site exists!

Democratic Republic of Congo / Canada

 

 

Section D: SOURCES OF FRAUDULENT

                   CLAIMS

 

 

23. Sources of fraudulent claims

 

 

Section E: DETECTION AND PREVENTION    

                   OF FRAUDULENT CLAIMS

 

 

24. Detection of fraudulent claims

 

25. Indicators of fraudulent claims

 

26. Prevention of fraudulent claims

 

 

Appendices

 

 

i)             Basic Questionnaire for foreign

Claimants

 

ii)            Police Abstract of Record of Accident

 

iii)           Post-mortem / Autopsy Report of

Medical Examiner or Practitioner

 

iv)           Medical Certificate of Cause of Death

 

v)            Certificate of Cremation (Cremation

Certificate)

vi)           Certificate of Registration of Death

(Certificate of Death or Death

Certificate)