Abstract: This research discussed medical insurance fraud in Kenya with a primary focus on investigating the effect of firm specific factors on medical insurance fraud in Kenya. The study was guided by four independent variables which included: ICT, internal control, professional experience and motivation of employees. The study adopted a descriptive research design. The target population of interest in this study comprised of all 170 unionisable staff members as well as the management staff of the selected insurance companies. The study utilized a sample size of 65.Primary data was collected using semi structured questionnaires containing both closed and open ended questions to allow variety. The quantitative data was analyzed using descriptive statistics. In addition the study used multiple regression analysis to analyze the data. The study concluded that though the medical insurance companies have invested a lot of money in the fraud prevention tools, they have not directed that investment to adopt standard online identity. The study concluded that the aspects of security controls such as passwords, protection of customer privacy, risk management framework and restrictions &control over transactions influence the fraud in the medical insurance company. This study therefore recommended that the insurance companies should direct their funds toward adopting standard online identity as well as investing in latest technology that counter imaging technique and other sophisticated gadgets that are used to commit medical insurance fraud. From the study findings and conclusion, the study also recommended that the top management in the medical insurance companies should ensure that they fully support fraud detection policies by allocating enough resources to acquire latest technology that counter imaging techniques used to commit fraud.
Keywords: Risk, firm specific factors, medical insurance company.
Title: Effect of Firm Specific Factors on Medical Insurance Fraud in Kenya
Author: JUSTUS MAUNDU, DR. WILLY MUTURI
International Journal of Management and Commerce Innovations
ISSN 2348-7585 (Online)
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