Försäkringsfusk. Tillvägagångssätt, straffansvar och försäkringsutredning

Sammanfattning: This study comprises three parts, each of which illustrates different aspects of insurance fraud. The three parts can be seen as independent presentations with their own research findings; but these parts may also be seen together as a whole, giving further perspectives regarding the subject of the study. Part I presents different procedures regarding insurance fraud. This part includes a survey which illustrates both what kind of modi operandi the policy holder has been using as well as the way in which the insurer has acted, but also the parallel development within public and private insurance. In Part II the modi operandi presented in Part I are examined in relation to the criminal law regulation regarding fraud and insurance crimes. The offence of insurance fraud has also been described more thoroughly. The individual policy holder’s situation is illustrated in Part III in the perspective of protection of the fundamental rights and freedoms. Hereby the diffuse line which in reality exists between the insurance investigation and the police investigation is described and it is shown that the insurer’s material for investigation can be relevant in a preliminary criminal investigation against the individual policy holder and be used against him without any proper control by a judicial authority. This material can also become relevant against the individual in a future trial in a criminal case. If the three parts are seen as a whole the problems regarding conflicting interests in the insurance system become apparent. Part I can be seen as a study in the perspective of the insurers illustrating irregularities committed against the insurance system. In Part II it is confirmed that some of these irregularities may be criminal, which means that the insurer has a legitimate motive for actions intended to prevent such irregularities. Part III adopts the perspective of the policy holders and illustrates the potential problems that may arise in respect of the individual’s fundamental rights and freedom if public criminal prosecution is initiated after a private criminal investigation.