INSURANCE FRAUD THROUGH COLLUSION BETWEEN POLICYHOLDERS AND CAR DEALERS: THEORY AND EMPIRICAL EVIDENCE Pierre PICARD

We analyze, from theoretical and empirical standpoints, how insurance distribution channels may a§ect fraud when policyholders and service providers collude. The empirical analysis focuses on the Taiwan automobile insurance market. Striking forms of claims manipulation exist in this market: opportunistic policyholders tend to manipulate claim dates to reduce the burden of deductibles and to take advantage of the bonus-malus mechanism. We focus our attention on the role of dealer-owned agents (DOAs), since they have informational and bargaining advantages when faced with insurers and may be tempted to encourage collusion between their car repairers and policyholders. We develop an optimal contract model with claim auditing, where contracts are sold either through DOAs or through standard independent agents, and where policyholders and car repairers may collude to manipulate claims. We also use a database from the largest Taiwanese insurance company to test for the relevance of theoretical predictions. In particular, we verify that fraud occurs through the postponing of claims to the end of the policy year, possibly by Öling one single claim for several events, and we show that the fraud rate is larger among policyholders who purchase insurance through the DOA channel than among other policyholders.