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As explained above, as there are a several parts / levels of

insurance policy life cycle; one may wonder why to learn all this

while learning fraud? Fraud / abuse can largely occurs with some

degree of misrepresentation and is an attempt to circumvent

any required step by – so that the risk management processes

set are bypassed/ hood winked. E.g. asking for a smaller sum

assured, while taking a life insurance product, to fall in the

group of auto underwriting and escape medical scrutiny.

14. Insurance Regulators:

Regulation of insurance in any country is assigned to a statutory

body that governs and regulates the insurance industry and

those engaged in the business of insurance.

This mammoth task is primarily enforced through regulations,

rules and directives by state insurance departments / central

governments as authorized and directed by statutory law

enacted by the nation’s legislatures. However, federal law,

court decisions and administrative adjudications also play an

important role.

1. India - The Insurance Regulatory and

Development Authority of India (IRDAI) is an autonomous,

statutory body tasked with regulating and promoting

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