Developing an intelligence and security framework to counteract insurance fraud in the low income sector. The case of Zimbabwe=Ukwakha ubuhlakani nohlaka  lwezokuphepha ukuze kuphikiswane nokukhwaniswa komshwayilense  endaweni yabahola kancane. Ucwaningo luzokwenzelwa eZimbabwe .

Nyangoni, Soul.

Developing an intelligence and security framework to counteract insurance fraud in the low income sector. The case of Zimbabwe=Ukwakha ubuhlakani nohlaka lwezokuphepha ukuze kuphikiswane nokukhwaniswa komshwayilense endaweni yabahola kancane. Ucwaningo luzokwenzelwa eZimbabwe .

Files

Nyangoni_Soul_2023.pdf (5.93 MB)

Date

2022

Authors

Nyangoni, Soul.

Abstract

This study explores avenues to develop a security and intelligence framework to counteract insurance fraud in the low-income sector in Zimbabwe. Insurance fraud, a threat to both national security and performance of the micro insurance industry, offering insurance services to low-income earners in Zimbabwe. The examination stretches from the causes of micro-insurance fraud to measures that can be fused with security intelligence to combat micro-insurance fraud. The framework of this study was a quantitative study, following stratified random sampling of three hundred and twenty-six participants. A structured questionnaire was deployed to collect primary data and complemented by interviews, focus groups and document inspection. The association between causes of insurance fraud, organised criminal syndicates, and low-income earners were investigated using structural equation modelling. The primary objective was to identify factors that enhance insurance fraud and measure the significance and causal effect of the identified variables. The response postulated that there are internal and external factors amongst them poor internal controls, lack of investment in artificial intelligence and poor human capital management systems which are being explored by organised crime syndicates to peddle micro insurance fraud. The internal and external factors work as an integrated front and the absence of one factor may negatively affect the decision to continue with the crime. In that regard, this study recommended the CEPSI strategy. The acronym CEPSI abbreviates for Customers, Employees, Participation, Systems and Intelligence and this is meant to overhaul microinsurance service provider’s operating systems. Conclusions were reached after synchronisation of primary and secondary data with research objectives. The CEPSI approach provide insurance firms with capabilities to detect, prevent, sanction, investigate, and remediate insurance fraud in the low-income sector of Zimbabwe. The focus is to equip the micro-insurance service providers with proactive capabilities meant to detect and thwart insurance fraud amongst policyholders, employees and organised crime syndicates by designing internal security measures fused with artificial intelligence to detect insurance fraud, educating the general public with regards to threats and consequences of insurance fraud and also working in liaison with security intelligence apparatus. Iqoqo Lolu cwaningo luzohlola imigudu yokwakha uhlaka lobuhlakani kanye nezokuphepha ukuze kuphikiswane nokukhwabaniswa kwemishwayilense endaweni yabahola kancane eZimbabwe. Ukukhwabaniswa komshwalense, ukusabisa kukho kokubili ezokuphepha kuzwelonke kanye nokusebenza kwemboni zomshwalense esencane, ukunikezela komsebenzi womshwalense kulabo abahola kancane eZimbabwe. Ukuhlola kuyodlulela nasezimbangeleni zokukhwabaniswa komshwalense okuncane kuye ezilinganisweni ezingahlanganiswa nobuhlakani bezokuphepha ukuze kuqedwe ukukhwabaniswa komshwalense omncane. Uhlaka lwalolu cwaningo kwakungolocwaningozinombolo, lulandela ukuqoka ngokohlelomkhakha okungahlelekile kwababambiqhaza abangamakhulu amathathu namashumi amabili nesithupha. Kwasetshenziswa uhlu lwemibuzo oluhleliwe ukuqoqa imininingo yokuqala kwahlanganiswa nezimposambuzo, amaqoqo azocwaningwa kanye nokuhlola imibhalo. Ukuhlobana phakathi kwezimbangela zokukhwabaniswa komshwalense, izinhlangano zobugebengu obuhleliwe kanye nabahola imali encane baphenywa kusetshenziswa imodelingi yesibalokulingana sesakhiwo. Inhlosongqangi yocwaningo kwakungukuhlonza izimo ezinokuthuthukisa ukukhwabaniswa komshwalense kanye nesilinganisi esimqoka nomphumela wamavariyebuli ahlonziwe. Impendulo yabeka ngokuyiqiniso ukuthi kunezimo zangaphandle nezangaphakathi phakathi kwezilawuli zangaphakathi ezimbi, ukungabibikho kophenyo kubuhlakani obungaziveleli kanye nezihlelo zokuphathwa kwengqalabhizinisi yabantu abaswele yahlolwa izinhlangano zobugebengu ezihlelelwe ukuthengisa ngokukhwabaniswa komshwalense osemncane. Izimo zangaphakathi nezangaphandle zibonakala zisebenza ngokuhlanganyela kodwa ngokungabibikho kwesimo esisodwa kungasiphazamisa kakhulu izinqumo sokuqhubeka nobugebengu. Ngaleyo ndlela, lolu cwaningo lwancoma isu iCEPSI. Isifinyezo iCEPSI sifinyeza Abathengi, Izisebenzi, Ukubamba iqhaza, Izinhlelo noBuhlakanikanti lokhu kwenzelwe ukulungisa kabusha izinhlelo zokusebenza kwabanikeza umsebenzi wemishwalense emincane. Kwafinyelelwa esiphethweni ngemuva kokuvumelanisa umniningo wokuqala nowesibili kanye nezinhloso zocwaningo. Indlela iCEPSI yanikezela ngamafemu omshwalense anokukwazi ukuthola, ukugwema, isijeziso, ukuphenya kanye nokulungisa ukukhwabaniswa komshwayilense endaweni yabahola kancane eZimbabwe. Okwakugxilwe kukho ukuhlomisa abancane abanikezela ngomsebenzi wokukhwabanisa umshwalense abanokukwazi ukuthola kanye nokuvimba ukukhwabaniswa komshwalense phakathi kwabanikazi benqubomgomo, izisebenzi kanye nezinhlangano zobugebengu obuhleliwe ngokuthi kusungulwe izinyathelo zokuphepha zangaphakathi zihlanganiswe nezobuhlakani obenziwe ukuze kutholwe ukukhwabaniswa komshwalense, ukufundiswa komphakathi owejwayelekile mayelana nokwesabisa kanye nemiphumela yokukhwabaniswa komshwalense kanye nokusebenza ngokuxhumana nezinsizakusebenza zezobuhlakani bezokuphepha.