{"id":740,"date":"2023-01-23T08:14:14","date_gmt":"2023-01-23T08:14:14","guid":{"rendered":"https:\/\/www.czechbankingnews.cz\/?p=740"},"modified":"2023-01-23T09:44:53","modified_gmt":"2023-01-23T09:44:53","slug":"gcp-odhalila-pojistne-podvody-za-vice-nez-pul-miliardy-korun","status":"publish","type":"post","link":"https:\/\/www.czechbankingnews.cz\/?p=740","title":{"rendered":"G\u010cP odhalila podvody za p\u016fl miliardy"},"content":{"rendered":"

Detektivov\u00e9 Generali \u010cesk\u00e9 poji\u0161\u0165ovny za uplynul\u00fd rok odhalili pojistn\u00e9 podvody, jejich\u017e uchr\u00e1n\u011bn\u00e1 hodnota p\u0159es\u00e1hla p\u016fl miliardy korun! Meziro\u010dn\u011b se toto \u010d\u00edslo nav\u00edc zv\u00fd\u0161ilo o 2,5 %, jde tedy op\u011bt o rekordn\u00ed \u010d\u00e1stku.<\/strong><\/p>\n

<\/p>\n

\u201eV lo\u0148sk\u00e9m roce jsme \u010delili velmi pestr\u00fdm snah\u00e1m o podvodn\u00e9 jedn\u00e1n\u00ed, a to jak z\u00a0\u0159ad jednotlivc\u016f, tak podnikatelsk\u00fdch subjekt\u016f. Potvrdila se na\u0161e dlouhodob\u00e1 zku\u0161enost, \u017ee slo\u017eit\u00e1 ekonomick\u00e1 obdob\u00ed p\u0159in\u00e1\u0161\u00ed mnoh\u00fdm nutk\u00e1n\u00ed z\u00edskat z\u00a0poji\u0161\u0165ovny pojistn\u00e9 pln\u011bn\u00ed neopr\u00e1vn\u011bn\u011b. To plat\u00ed mnohdy i o snaze z\u00edskat neopodstatn\u011bn\u011b vy\u0161\u0161\u00ed \u010d\u00e1stku,\u201c<\/em> vysv\u011btluje Petr Kafka, \u0161\u00e9f \u00fatvaru vy\u0161et\u0159ov\u00e1n\u00ed Generali \u010cesk\u00e9 poji\u0161\u0165ovny.
\nPojistn\u00fd podvod je posuzov\u00e1n jako trestn\u00fd \u010din podle\u00a0\u00a7 210 trestn\u00edho z\u00e1kon\u00edku\u00a0\u2013 pachatel za n\u011bj m\u016f\u017ee b\u00fdt odsouzen k trestu odn\u011bt\u00ed svobody ve v\u00fd\u0161i a\u017e 10 let.<\/p>\n

PODNIK\u00c1N\u00cd I \u0160KODY NA ZDRAV\u00cd<\/strong><\/p>\n

Nej\u010dilej\u0161\u00ed podvodn\u00e9 jedn\u00e1n\u00ed bylo odhaleno v\u00a0oblasti podnikatelsk\u00e9ho poji\u0161t\u011bn\u00ed, kde uchr\u00e1n\u011bn\u00e1 hodnota p\u0159ed neopr\u00e1vn\u011bnou v\u00fdplatou p\u0159es\u00e1hla 310 milion\u016f korun. \u0160lo p\u0159edev\u0161\u00edm o p\u0159\u00edpady z\u00a0majetkov\u00e9ho a odpov\u011bdnostn\u00edho poji\u0161t\u011bn\u00ed.<\/p>\n

P\u0159ekvapiv\u011b druhou oblast\u00ed jsou \u0161kody na zdrav\u00ed vypl\u00e1cen\u00e9 z\u00a0povinn\u00e9ho ru\u010den\u00ed. Zde uchr\u00e1n\u011bn\u00e1 hodnota p\u0159es\u00e1hla 110 milion\u016f korun, co\u017e je meziro\u010dn\u00ed n\u00e1r\u016fst o 63 %. Za touto \u010d\u00e1stkou stoj\u00ed p\u0159edev\u0161\u00edm odhalen\u00e9 p\u0159\u00edpady, kdy si lid\u00e9 navy\u0161uj\u00ed um\u011ble sv\u00e9 mzdy, aby z\u00edskali vy\u0161\u0161\u00ed vyplacenou rentu. Nejsou schopni p\u0159itom takov\u00fd d\u016fkaz p\u0159esv\u011bd\u010div\u011b dolo\u017eit.<\/p>\n

Na t\u0159et\u00ed p\u0159\u00ed\u010dce se um\u00edstily podvody p\u00e1chan\u00e9 z\u00a0titulu \u017eivotn\u00edho poji\u0161t\u011bn\u00ed. Jestli\u017ee v\u00a0roce 2021 jich na\u0161i detektivov\u00e9 odhalili v\u00a0\u00fahrnu za 8,2 milionu, loni tato suma dos\u00e1hla t\u00e9m\u011b\u0159 38 milion\u016f korun. I zde se objevily snahy \u0159e\u0161it existen\u010dn\u00ed probl\u00e9my t\u00edmto typem poji\u0161t\u011bn\u00ed.
\nK n\u00e1r\u016fst\u016fm v\u00a0objemech uchr\u00e1n\u011bn\u00e9 hodnoty za lo\u0148sk\u00fd rok pak do\u0161lo tak\u00e9 v\u00a0oblasti poji\u0161t\u011bn\u00ed motorov\u00fdch vozidel. O 63 % narostla hodnota podvod\u016f, kter\u00e9 jsou v\u00a0p\u0159\u00edm\u00e9 souvislosti s\u00a0v\u00fdplatou pojistn\u00e9ho pln\u011bn\u00ed z\u00a0havarijn\u00edho poji\u0161t\u011bn\u00ed po kr\u00e1de\u017ei vozidel. Poda\u0159ilo se uchr\u00e1nit neopr\u00e1vn\u011bnou v\u00fdplatu za v\u00edce ne\u017e 12 milion\u016f korun.<\/p>\n

V\u00a0POLOVIN\u011a KRAJ\u016e V\u00cdCE PODVOD\u016e<\/strong><\/p>\n

V\u00a0polovin\u011b kraj\u016f do\u0161lo meziro\u010dn\u011b ke zv\u00fd\u0161en\u00ed odhalen\u00fdch podvod\u016f. Nejv\u011bt\u0161\u00ed n\u00e1r\u016fst detektivov\u00e9 zaznamenali v\u00a0Moravskoslezsk\u00e9m kraji a na Liberecku, a to o v\u00edce ne\u017e 50 %.<\/p>\n

Z\u00a0pohledu region\u016f absolutn\u011b se meziro\u010dn\u011b nezm\u011bnila prvn\u00ed p\u0159\u00ed\u010dka: nejvy\u0161\u0161\u00ed objem podvod\u016f detektivov\u00e9 odhalili v\u00a0Praze, a to za t\u00e9m\u011b\u0159 126 milion\u016f korun.
\nNa druh\u00e9m m\u00edst\u011b ve statistik\u00e1ch zakotvil \u00dasteck\u00fd kraj, kter\u00fd objemem odhalen\u00fdch podvod\u016f (78 milion\u016f K\u010d) p\u0159ekonal dokonce St\u0159edo\u010desk\u00fd kraj (62 milion\u016f K\u010d).<\/p>\n

Nejm\u00e9n\u011b podvodn\u00fdch aktivit Generali \u010cesk\u00e1 poji\u0161\u0165ovna zaznamenala tradi\u010dn\u011b na Vyso\u010din\u011b. Meziro\u010dn\u011b \u0161lo o pokles o milion na v\u00fdsledn\u00fdch 3,5 milionu K\u010d.<\/p>\n

DATOV\u00c1 ANAL\u00ddZA<\/strong><\/p>\n

Pojistn\u00e9 podvody se nejv\u011bt\u0161\u00ed dom\u00e1c\u00ed poji\u0161\u0165ovn\u011b da\u0159\u00ed odhalovat p\u0159edev\u0161\u00edm d\u00edky zku\u0161en\u00fdm odborn\u00edk\u016fm \u2013 \u201edetektiv\u016fm\u201c, kte\u0159\u00ed se pod\u00edlej\u00ed p\u0159\u00edmo na \u0161et\u0159en\u00ed podez\u0159el\u00fdch pojistn\u00fdch ud\u00e1lost\u00ed, ale i t\u00fdmu analytik\u016f, kte\u0159\u00ed poskytuj\u00ed\u00a0 on-line datovou a analytickou podporu p\u0159i tomto \u0161et\u0159en\u00ed.\u201e\u00dasp\u011b\u0161nost n\u00e1m pom\u00e1h\u00e1 v\u00fdrazn\u011b zlep\u0161ovat krom\u011b profesion\u00e1l\u016f v oboru zejm\u00e9na datov\u00e1 anal\u00fdza pojistn\u00fdch ud\u00e1lost\u00ed, kter\u00e1 s\u00a0vyu\u017eit\u00edm um\u011bl\u00e9 inteligence i strojov\u00e9ho u\u010den\u00ed dosahuje pozoruhodn\u00fdch v\u00fdsledk\u016f,\u201c<\/em> up\u0159es\u0148uje Petra Kafka, \u0161\u00e9f \u00fatvaru vy\u0161et\u0159ov\u00e1n\u00ed Generali \u010cesk\u00e9 poji\u0161\u0165ovny.<\/p>\n

Kuna, kouzlo se smlouvou a soud<\/p>\n

Klient nahl\u00e1sil z majetkov\u00e9ho poji\u0161t\u011bn\u00ed po\u0161kozen\u00ed tepeln\u00e9 izolace a paroz\u00e1brany st\u0159echy rodinn\u00e9ho domu. \u0160kodu za 70 000 K\u010d m\u011bla zp\u016fsobit kuna. O tom pochyb nebyl. Detektivov\u00e9 poji\u0161\u0165ovny ale v\u011bnovali pozornost podez\u0159el\u00fdm okolnostem v souvislosti s \u00fapravou pojistn\u00e9 smlouvy p\u0159ed vznikem pojistn\u00e9 ud\u00e1losti.<\/p>\n

Uk\u00e1zalo se \u0161et\u0159en\u00edm, \u017ee zat\u00edmco faktura za opravy byla vyd\u00e1na v\u00a0b\u0159eznu, pr\u00e1ce prob\u011bhly na z\u00e1klad\u011b objedn\u00e1vky a cenov\u00e9 nab\u00eddky ji\u017e v\u00a0lednu. Av\u0161ak v\u00a0\u00fanoru si majitel rodinn\u00e9ho domu nechal p\u0159epracovat pojistnou smlouvu, kam zahrnul nov\u011b i riziko \u201epo\u0161kozen\u00ed zateplen\u00ed a oplocen\u00ed zv\u00ed\u0159aty\u201c, kter\u00e9 p\u016fvodn\u011b sjednan\u00e9 nem\u011bl.
\nNesrovnalosti v cel\u00e9m p\u0159\u00edpadu prok\u00e1zaly i fotografie dolo\u017een\u00e9 \u0161kody. Mezi nimi toti\u017e majitel domu zanechal i ty, kter\u00e9 nesly datovou stopu po\u0159\u00edzen\u00ed je\u0161t\u011b p\u0159ed datem aktualizace smlouvy na \u0161kody zp\u016fsoben\u00e9 kunou. I kdy\u017e byl majitel domu s\u00a0t\u011bmi skute\u010dnostmi konfrontov\u00e1n, trval na v\u00fdplat\u011b pojistn\u00e9ho pln\u011bn\u00ed. Cel\u00e1 ud\u00e1lost tak byla p\u0159ed\u00e1na org\u00e1n\u016fm \u010dinn\u00fdm v\u00a0trestn\u00edm \u0159\u00edzen\u00ed.<\/p>\n

Dva pohledy Petra Kafky, \u0161\u00e9fa \u00favaru vy\u0161et\u0159ov\u00e1n\u00ed Generali \u010cesk\u00e9 poji\u0161\u0165ovny<\/p>\n

PODVODY VS. ORGANIZOVAN\u00c9 SKUPINY<\/strong>
\nZde mluv\u00edme o vylo\u017een\u011b promy\u0161len\u00fdch \u010dinech, kter\u00fdmi zlo\u010dineck\u00e9 skupiny p\u00e1chaj\u00ed organizovanou trestnou \u010dinnost. Co do po\u010dtu nejde o vysok\u00e1 \u010d\u00edsla, z\u00e1sadn\u00ed jsou v t\u011bchto p\u0159\u00edpadech finan\u010dn\u00ed objemy. V t\u011bchto p\u0159\u00edpadech se bav\u00edme i o des\u00edtk\u00e1ch milion\u016f korun. Typicky jde o oblast \u0161kod z\u00a0poji\u0161t\u011bn\u00ed motorov\u00fdch vozidel, ale tak\u00e9 z podnikatelsk\u00e9ho poji\u0161t\u011bn\u00ed.
\nPozoruhodn\u00e9 je, \u017ee n\u011bkte\u0159\u00ed\u00a0 podnikatel\u00e9 se o pojistn\u00fd podvod pokou\u0161\u00ed bez ohledu na ekonomickou situaci zem\u011b. Setk\u00e1v\u00e1me se tak s takov\u00fdm jedn\u00e1n\u00edm v dob\u011b recese i konjunktury.<\/p>\n

PODVODY VS. B\u011a\u017dN\u00cd LID\u00c9<\/strong>
\nV\u00a0oblasti pokus\u016f o pojistn\u00fd podvod se ocit\u00e1 \u0159ada jinak bez\u00fahonn\u00fdch ob\u010dan\u016f v\u00a0situaci, kdy se pokou\u0161\u00ed z\u00e1m\u011brn\u011b nav\u00fd\u0161it \u0161kodu u skute\u010dn\u011b vznikl\u00e9 pojistn\u00e9 ud\u00e1losti. Zar\u00e1\u017eej\u00edc\u00ed je, \u017ee lid\u00e9 takov\u00e9 jedn\u00e1n\u00ed nepova\u017euj\u00ed za \u0161patn\u00e9 a neuv\u011bdomuj\u00ed si, \u017ee se t\u00edm dopou\u0161t\u00ed trestn\u00e9ho \u010dinu – pokusu o pojistn\u00fd podvod. V takov\u00fdch p\u0159\u00edpadech se pak v\u011bt\u0161inou jedn\u00e1 sp\u00ed\u0161e o ni\u017e\u0161\u00ed \u010d\u00e1stky v \u0159\u00e1dech tis\u00edc\u016f max. desetitis\u00edc\u016f korun.<\/p>\n

Z\u00a0na\u0161\u00ed dlouholet\u00e9 praxe v\u00edme, \u017ee pouze men\u0161ina pojistn\u00fdch podvod\u016f je od za\u010d\u00e1tku promy\u0161len\u00fdm \u010dinem. Lid\u00e9 si v\u011bt\u0161inou nesjedn\u00e1vaj\u00ed poji\u0161t\u011bn\u00ed s \u00famyslem, \u017ee sp\u00e1chaj\u00ed pojistn\u00fd podvod.<\/p>\n

Nej\u010dast\u011bji doch\u00e1z\u00ed k tomu, \u017ee \u010dlov\u011bk podlehne t\u00edze okam\u017eiku. K pojistn\u00e9 ud\u00e1losti skute\u010dn\u011b dojde, ale klient se pot\u00e9 sna\u017e\u00ed poji\u0161\u0165ovnu p\u0159esv\u011bd\u010dit o tom, \u017ee mu vznikla daleko v\u011bt\u0161\u00ed \u0161koda, ne\u017e tomu ve skute\u010dnosti bylo.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Detektivov\u00e9 Generali \u010cesk\u00e9 poji\u0161\u0165ovny za uplynul\u00fd rok odhalili pojistn\u00e9 podvody, jejich\u017e uchr\u00e1n\u011bn\u00e1 hodnota p\u0159es\u00e1hla p\u016fl miliardy korun! Meziro\u010dn\u011b se toto \u010d\u00edslo nav\u00edc zv\u00fd\u0161ilo o 2,5 […]<\/a><\/p>\n<\/div>","protected":false},"author":2,"featured_media":741,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[],"class_list":["post-740","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-pojistovny"],"_links":{"self":[{"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=\/wp\/v2\/posts\/740","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=740"}],"version-history":[{"count":2,"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=\/wp\/v2\/posts\/740\/revisions"}],"predecessor-version":[{"id":748,"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=\/wp\/v2\/posts\/740\/revisions\/748"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=\/wp\/v2\/media\/741"}],"wp:attachment":[{"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=740"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=740"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.czechbankingnews.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=740"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}