Citation

Tennyson S, Salsas-Forn P. J. Risk Insur. 2002; 69(3): 289-308.

Copyright

(Copyright © 2002, American Risk and Insurance Association, Publisher John Wiley and Sons)

DOI

10.1111/1539-6975.00024

PMID

unavailable

Abstract

Research on insurer management of opportunism in claiming has developed in two parallel literatures. One is a theoretical literature on insurance contracting that yields predictions about the nature of optimal auditing strategies for the deterrence of fraud. The other is a literature based upon statistical analysis of claims that yields empirical strategies for the detection of fraudulent claims. This article links the two literatures by providing an empirical assessment of insurers' auditing practices in relation to theoretical predictions. The analysis makes use of a data set on the disposition of more than 1,000 randomly selected automobile personal injury protection claims settled in the state of Massachusetts. The findings of the article are consistent with the use of rational auditing strategies by insurers and with the use of audits for both deterrence and detection.