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Abstract The insurance system has now become one of the indispensable economic activities. With the vigorous development of economic activities such as insurance system, the insurance fraud has also diversified itself with more innovative and smarter approaches. Unlike usual violent crimes, insurance fraud is categorized as “smart crime”, which makes it more difficult to detect, investigate and solve. Among all those crimes, insurance fraud has drawn the most attention by the government, the public and the news. There are various ways to commit an insurance fraud, for instance, self-mutilation, faking death by purchasing corpses, murdering to obtain insurance benefits, purchasing insurance for a person then fake the accident, arson, fake car accident, false report theft of own car, transporting valuable goods on purpose to obtain car insurance by damaging the car, forgery, false self-embezzlement, etc. Despite of the challenges to identify crime activities among these enormous superficialities, it is much less laborious to trace property lost than to pinpoint personal type insurance frauds. As a result, searching for the approaches of personal type insurance frauds is urgently required. This paper collects data from The Judicial Yuan of the Republic of China Law and Regulations Retrieving System, targeting on personal type insurance frauds with keyword “insurance company” from 2009 to 2014. Initially, there are in total of 4000 cases with keyword “insurance company” has been sifted. And then by screening to the specific type of personal insurance fraud, the data has been funneled down to 57 cases. Finally, 40 out of the 57 cases are found out to be directly related to the subject of this paper. According to the analysis of the verdict and the categorization, this paper identifies a prevalence of insurance fraud in middle and southern regions of Taiwan, with more cases in Taichung, Kaohsiung and Tainan. Also, it shows that insurance fraud has a tendency to reach its peak within one year of purchasing the insurance by suspects. Also, those accomplices are tend to be the suspect’s relatives and friends. In order to detect an insurance fraud from the verification of insurance company to intervention of the jurisdiction investigation, the thorough examination and close cooperation between the insurance company and the jurisdiction are of the essence. To conclude, it is crucially important for the insurance company to scrutiny their clients step by step to prevent the insurance fraud. Furthermore, to increase the insurance fraud detection rate, the jurisdiction should consider establishing a special division responsible for insurance fraud, regulating commission and evaluating standard guidelines.
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