Consumer Insurance Fraud/Abuse as Co-creation and Co-responsibility: A New Paradigm

This article discusses the implications of moral dissonance for managers, and how dissonance induced self justification can create an amplifying feedback loop and downward spiral of immoral behaviour. After addressing the nature of moral dissonance, including the difference between moral and hedonistic dissonance, the writer then focuses on dissonance reduction strategies available to managers such as rationalization, self affirmation, self justification, etc. It is noted that there is a considerable literature which views the organization as a potentially corrupting institution and a source of acute levels of moral dissonance. A simplified process model linking immoral behaviour, dissonance and rationalization is mooted, and some recent theories which question traditional dissonance models, including the free choice paradigm (FCP), are considered. The writer concludes that in the light of the above mentioned critical theories, it may be assumed that the levels of moral dissonance, and the extent of rationalization/self justification amongst managers, are more a function of personality and situational factors than previously assumed.     

Coping with Consumer Fraud: The Need for a Paradigm Shift

A review of recent informational initiatives to help consumers avoid being defrauded revealed that advice offered draws heavily on past fraud cases in which swindlers were successful in victimizing consumers. This article draws upon behavioral theory to argue that such case studies are limited in usefulness. It is further argued that a paradigm shift is needed to focus on unsuccessful efforts by swindlers to defraud consumers. An investigation that surveyed such case studies is summarized with illustrations presented of how its findings could be used to help consumers cope more effectively with threats posed by swindlers.     

Perceptions of the Ethicality of Consumer Insurance Claim Fraud

It was proposed that ethical evaluation of insurance claim padding behavior would be affected by characteristics of the policyholder, insurance agent, and company. These three factors were manipulated in written scenarios and the premise was tested in a factorial experimental design. No significant support was found for an effect of any of the three factors on ethical perceptions of claim padding. However, females found claims padding to be significantly less ethical than males. Given a claim scenario where the actual loss was $500 and the claimed amount was $3000, subjects awarded an average of $986.91 on the claim. Many respondents were willing to compensate victims for intangible losses as well as tangible losses.     

Consumer Vulnerability to Fraud: Influencing Factors

Using the 1993 Survey of Older Consumer Behavior commissioned by the American Association of Retired Persons, consumer vulnerability to market fraud was investigated. Consumer vulnerability was determined based on consumers' market knowledge and awareness of unfair business practices. Using an ordered logit analysis, it was found that consumers were more susceptible to fraud if they were older, poor, less educated, and/or living without spouse. Neither gender nor race was found to be a significant predictor of consumer vulnerability. Implications for consumer educators and policy makers were drawn.     

A Proposed Paradigm for Consumer Product Disposition Processes

The study of consumer behavior has dealt largely with acquisition and consumption. Very little attention has been given to a third stage-disposition. This paper presents a paradigm of consumer product disposition processes. The paradigm shows the person, product and situation as components influencing the disposition process.     

The Abuse of the “Confident Consumer” as a Justification for EC Consumer Law

A reference to the need to create confident cross-border consumers who can contribute to the strengthening of the internal market has often been used as one of the main arguments for EC consumer policy and legislation. The argument has been presented in order to justify both the creation of a minimum safety net for consumers (the minimum confidence argument) and the current turn towards more total harmonisation of consumer protection (the harmonised confidence argument). In the paper these lines of argument are critically evaluated with reference to common sense knowledge about the behaviour of consumers as well as on the basis of Eurobarometer data concerning consumer confidence. In this light the substantive minimum harmonisation measures which have been justified with reference to the need for promoting consumer confidence seem only to a limited extent relevant with respect to the creation of such confidence. The current turn towards total harmonisation most certainly cannot be justified in this way. Other substantive measures, facilitating the access to a counterparty, would be more important in order to create consumer confidence in cross-border shopping, but the Community has almost systematically avoided adopting such measures.     

Diversity Management: A New Organizational Paradigm

Currently, an increasing number of organizations are attempting to enhance inclusiveness of under represented individuals through proactive efforts to manage their diversity. In this article, we define diversity management against the backdrop of its predecessor, affirmative action. Next, selected examples of organizations that have experienced specific positive bottom line results from diversity management strategies are discussed. The present paper also provides a conceptual model to examine antecedents and consequences of effective diversity management. Additional research areas identified from the model and literature review result in a number of research propositions intended to enhance the exploration and understanding of diversity management.     

从“产品主导逻辑”到“顾客参与的价值共创”——看西方服务范式四十年来的理论演进

服务研究已经成为近四十年来的热点研究问题,从传统经典理论发展出的产品主导逻辑到服务主导逻辑与价值共创,服务范式的研究不断演进,如何认知服务的问题一直是学术界讨论的热点,文章对服务范式研究的发展历史与演进过程进行了梳理和分析,归纳、识别了包括产品主导逻辑、服务特征范式、关系主导范式、顾客接触范式、服务体验范式、服务主导逻辑和统一服务理论等七种不同的服务范式,分析了当前研究中的不足和面临的挑战,并对未来的研究方向进行了展望。     

Consumer Choice: A Study of Insurance Buying Intention,Attitudes and Beliefs

This article continues the theme, introduced in a previous article, of testing the validity and relevance of Fishbein's Theory of Reasoned Action to the purchase of life assurance. In this, the second stage, empirical analysis of the data is conducted and its meaning and relevance considered. Conclusions are then drawn as to the dimensions which seem to be important to the purchasing of life assurance.     

When Lying Does Not Pay: How Experts Detect Insurance Fraud

A growing literature has focused on understanding how to detect and deter unethical consumer behavior. In this work, we focus on a particularly important type of unethical consumer behavior, consumer insurance fraud, and we analyze a unique dataset to understand how experts investigate suspicious claims. Two separate but related literatures inform the process of investigating suspicious insurance claims. The first literature is grounded in field research and emphasizes the importance of secondary sources. The second literature is grounded in laboratory studies that emphasize the importance of interpersonal interactions. Here we draw upon both literatures to consider the importance of claimant interviews within the context of many investigative actions and the potential for claimants to avoid interviews. In an empirical study using qualitative and quantitative data from auto insurance claim investigations, we analyze investigative chronologies conducted by skilled experts. In doing so, we find that even when investigators can access information from a variety of sources such as witnesses, databases, and physical evidence, claimant interviews are the most important step in determining whether or not claims are denied or paid. Furthermore, we identify interpersonal avoidance as an important signal of unethical claimant behavior. Our findings inform deception detection theory and practice. We identify implications for deception detection in business, particularly for consumer unethical behavior and insurance fraud investigations.     

Information Technology and Consumer Search for Health Insurance

We explore the impact of information technology on the level of premiums paid for individual health insurance by asking which kinds of buyers will have larger gains from the use of new technology. We compare ‘asking price’ data posted on an electronic insurance exchange with survey data on premiums actually paid before the advent of exchange and examine whether the pattern of differences between asking prices and transactions prices can be explained using a simple search theory. We hypothesize that older consumers, expecting to pay higher premiums for a given policy, had engaged in more intensive search than younger consumers, given the same distribution of prices and search costs. Therefore, the introduction of an electronic exchange that lowers the cost of search should have a larger effect on decreasing the level of premiums paid for those who previously searched less (i.e., younger consumers). We find evidence consistent with this hypothesis.     

Consumer Bankruptcy in the United States: A Study of Alleged Abuse and of Local Legal Culture

This paper describes certain central aspects of the operation of the consumer bankruptcy system in the United States. It combines government data with the investigators' empirical data from two large studies done over a decade to explore two types of questions. The first area of investigation relates specifically to bankruptcy policy. The object is to identify the categories of persons principally served by the consumer bankruptcy system and to determine if suggestions of widespread abuse of that system by debtors are well-founded. The paper reports that the system is used primarily by the middle-class. It also reports that there is no evidence of widespread abuse. The second area of investigation is explanation of differences in the operation of the system in different regions of the country, differences that have persisted over twenty years despite major changes in legal rules and economic conditions. The paper argues that these differences are not explicable in terms of formal legal rules or a simple economic model and that a better explanation of the data is that the differences are the product of a "local legal culture" in each region.     

Impacts of Insurance on the Demand and Utilization of Drug Abuse Treatment: Implications for Insurance Mandates

This article addresses costs and utilization for mental health/substance abuse treatment, with particular emphasis on the emerging importance of self-insured coverage in the 1990s. We estimate drug abuse treatment demand and utilization with an insurance claims database from self-insured employers. The study population was selected from a large database consisting of health insurance claims for all treatment events starting 1 January 1989 and ending 31 December 1991. Approximately three-quarters of the increase in in-patient usage attributable to fractional co-insurance is due to increased usage per person (the other one-quarter refers to increased numbers of users). About half of the increase in outpatient usage is due to increased usage per person. In summary, our estimates provide useful measurements of the potential impacts of improved drug abuse treatment coverage. Although the potential induced in-patient expenditures and dead-weight losses are substantial compared to co-insurance rates of 0.5, losses can be trimmed by adjusting co-insurance, even at rates of approximately 0.1.     

论消费者权益保护的范式转换

消费者权益保护存在抽象交易范式、具体交易范式、消费行为范式、服务合同范式等。抽象交易范式中,消费者属基于配平交易关系需要顾及到的主体之一,其保护不具独立意义,客观上得到制度性关照在于保护获得平等的交易机会。具体交易范式以德国立法例为代表,其通过与经营者营业或职业行为对照,确立消费者全方位弱的弱者地位,权益保护的目的旨在实现具体交易公平。消费行为范式以生活消费界定消费者概念,消费行为属自然人民事主体资格的组成部分,具有超越于商事行为的法律价值,为消费者权益保护提供私法层面的解释。服务合同范式立足于生活消费在服务业主导产业结构下的时代特征,实现消费者概念向民法典民事主体制度的回归,并促进经营者商行为伦理性的现代重塑。     

Consumer Preferences and Customer Satisfaction Analysis: A New Method Proposal

The organic food market is currently the fastest growing food sector in the United States, with growth rates in organic food sales averaging 17% per year between 1998 and 2006. The largest segment within the organic market is fresh produce, comprising 34% percent of retail sales in 2006. This analysis focuses on identifying the demographic characteristics of households buying organic vegetables (in total) along with prepackaged organic salads and organic carrots, by examining the factors that influence the probability that a consumer will buy organic vegetables, and which factors influence the household share of organic vegetables purchased. We use Nielsen Homescan data for the year 2004. Households with high levels of education are more likely to purchase organic vegetables, while the probability of purchasing organic vegetables is lower for African Americans and for older households.     

Consumer Information,Insurance, and Doctor Shopping: The Elderly Consumer's Perspective

One possible strategy to minimize costs of health care is to provide consumers with information pertaining to its relative cost. However, the effectiveness of programs to dispense information on medical services has been difficult to evaluate because very little is known about incentives for doctor shopping. The demand for medical services information (doctor shopping) among elderly consumers and the effect of health insurance purchases on shopping decisions are assessed.     

Corporate Fault and Consumer Protection: A New Approach for the UK

Many of the prosecutions for consumer protection offences which take place in the UK are against corporations, in particular, limited companies. As the criminal law had originally developed with human defendants in mind, many of its concepts were inappropriate where the defendant was a corporation. Corporations have, it is sometimes said, "no soul to be damned and no body to be kicked." As a result of industrialisation and the rise of the corporation in everyday life, legal principles had to be developed to deal with this new form of legal person. It began to be recognised that as well as having the ability to own property, enter contracts and the like, corporations were also capable of committing criminal offences.The purpose of this article is to examine the ways in which a corporation can be convicted of committing consumer protection offences under UK law. This is a topic which has received considerable attention in recent years, and is one which continues to undergo change. In particular, the article will consider the implications of a number of important recent decisions on corporate liability, and will consider their implications for those concerned with the enforcement of consumer law. It will be argued that the recent case law suggests that a new approach has emerged, but that the extent and implications of this approach, although potentially highly significant, are still not entirely clear.