Collusion Between Retailers and Customers: The Case of Insurance Fraud in Taiwan

This study analyzes how the insurance distribution channel can affect insurance fraud. It uses econometric models that confirm the existence of claim manipulation as a form of insurance fraud, whereby policyholders circumvent the bonus–malus system and reduce the actual burden of insurance deductibles. The econometric approach is based on joint regression models for the probability that a claim is manipulated on one hand, and the probability that the policyholder has strong incentives to do so, on the other hand. The estimation shows that there is a significantly positive residual correlation between these regressions, which establishes the likelihood of fraudulent claim manipulation. The econometric modelling of claim cost allows us to disentangle the manipulation of claims that correspond to true losses and small false claims filed at the end of the policy year, and also to highlight the role of the insurance distribution channel in these fraud mechanisms. Using data from two Taiwanese car insurers with very different distribution channels in 2010, we compare an insurer that relies heavily on dealer-owned agents (DOAs) with another insurer that does not rely on DOAs at all. We find strong evidence of severe claim manipulation when insurance is sold through DOAs. Moreover, as the first insurer significantly reduced its reliance on the DOA channel over time, we perform a before–after comparison using data from 2010 and 2018. The results show that the claim manipulation fraud previously observed in the DOA channel decreases as the market share of this distribution channel is reduced. All these results highlight the role of automobile insurance agencies in facilitating this fraud process. The theoretical underpinnings of our analysis are provided by a claim fraud model considering collusion and audit.