Demographic Perspectives On Consumer Insurance Frauds And Its Implications On Intervention Measures In Nairobi City County, Kenya

ABSTRACT

The study explored the demographic perspectives on consumer insurance frauds and its implication on intervention measures. The objective of the study was to explain the nature and features of consumer insurance fraud, to examine the demographic characteristics of consumer insurance fraudsters and to propose strategies for the management of consumer insurance fraud. The study was guided by three theories: Rational Choice Theory, Routine activity Theory and Differential Association Theory to explain why individuals engage in the commission of consumer insurance fraud. The study adopted a descriptive study design which incorporated both qualitative and quantitative data collection methods. The target population included all the 750 staff working in the 47 insurance companies in Kenya in claim processing. The sample population included ten percent of the target population which is 75. Purposive sampling technique was used to select 9 insurance fraud investigators from police (Insurance Fraud Investigation Unit), 8 private insurance investigators and 8 internal fraud investigators in insurance companies. The total sample size was 100. The data was analysed using descriptive statistics for quantitative survey and content analysis for qualitative data. The data was presented in pie charts, bar graphs and frequency tables. Qualitative data was presented as verbatim quotes. The findings showed that age, gender, education level, and income levels are important in assessing the characteristics of insurance fraudster. The results of this study support the assumptions that the demographic factors play specific role of in the individual’s perception of acceptability of insurance fraud. The study’s findings were valuable to the police and the insurance industry regulator in improving insurance fraud management. The study provided knowledge on how best to prevent consumer insurance fraud, being that most of them are private businesses. The study provided insights to the insurance industry, National Police Service and the Insurance Fraud Investigation Unit in particular the demographic characteristics of consumer insurance fraud perpetrators. The study recommends that further studies should look into the psychosocial characteristics of consumer insurance fraud, and the implications of psychosocial characteristics on interventions.