Developing an intelligence and security framework to counteract insurance fraud in the low income sector. The case of Zimbabwe.
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Date
2022
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Abstract
This study explores avenues to develop a security and intelligence framework to counteract insurance fraud in the low-income sector in Zimbabwe. Insurance fraud, a threat to both national security and performance of the micro insurance industry, offering insurance services to low-income earners in Zimbabwe. The examination stretches from the causes of micro-insurance fraud to measures that can be fused with security intelligence to combat
micro-insurance fraud. The framework of this study was a quantitative study, following stratified random sampling of three hundred and twenty-six participants. A structured questionnaire was deployed to collect primary data and complemented by interviews, focus groups and document inspection. The association between causes of insurance fraud, organised criminal syndicates, and low-income earners were investigated using structural equation modelling. The primary objective was to identify factors that enhance insurance fraud and measure the significance and causal effect of the identified variables. The response postulated that there are internal and external factors amongst them poor internal controls,
lack of investment in artificial intelligence and poor human capital management systems which are being explored by organised crime syndicates to peddle micro insurance fraud. The internal and external factors work as an integrated front and the absence of one factor may negatively affect the decision to continue with the crime. In that regard, this study recommended the CEPSI strategy. The acronym CEPSI abbreviates for Customers,
Employees, Participation, Systems and Intelligence and this is meant to overhaul microinsurance service provider’s operating systems. Conclusions were reached after synchronisation of primary and secondary data with research objectives. The CEPSI approach provide insurance firms with capabilities to detect, prevent, sanction, investigate, and remediate insurance fraud in the low-income sector of Zimbabwe. The focus is to equip the
micro-insurance service providers with proactive capabilities meant to detect and thwart insurance fraud amongst policyholders, employees and organised crime syndicates by designing internal security measures fused with artificial intelligence to detect insurance fraud, educating the general public with regards to threats and consequences of insurance fraud and also working in liaison with security intelligence apparatus.
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Doctoral Degree. University of KwaZulu-Natal, Durban.