This Code presents the general principles and minimum standards that should be met by insurance and reinsurance companies, including branches of foreign insurance and reinsurance companies, and insurance related service providers to prevent or at least minimize the occurrence of fraud.
The objective of This Code is to promote high standards of fraud detection and prevention.
This Code must be read in conjunction with the Law on Supervision of Cooperative Insurance Companies and its Implementing Regulations, in particular articles 2, 10, 12, 15, 19, 25, 28, 31, 43, 56, 71, 76 and 77.
The term “Companies” in This Code is intended to include: insurance and reinsurance companies, and insurance related service providers including insurance brokerages, insurance agencies, reinsurance brokerages, and reinsurance agencies. The rest of the terms used in This Code shall have the same meaning as per article one (1) of the Implementing Regulations.
Insurance fraud is defined1 as an act or omission of an act intended to gain dishonest or unlawful advantage for the party committing the fraud or for other parties. This may, for example, be achieved by means of:
a) Misappropriating assets.
b) Deliberately misrepresenting, concealing, suppressing or not disclosing one or more material facts relevant to a financial decision, transaction or perception of the insurer’s status.
c) Abusing authority, a position of trust or a fiduciary relationship.
This Code applies to insurance and reinsurance companies, and insurance related service providers including insurance brokerages, insurance agencies, reinsurance brokerages, and reinsurance agencies.