Recent scholarship in philosophy, law, and information systems suggests that respecting privacy entails understanding the implicit privacy norms about what, why, and to whom information is shared within specific relationships. These social contracts are important to understand if firms are to adequately manage the privacy expectations of stakeholders. This paper explores a social contract approach to developing, acknowledging, and protecting privacy norms within specific contexts. While privacy as a social contract—a mutually beneficial agreement within a community about sharing and using (...) information—has been introduced theoretically and empirically, the full impact on firms of an alternative framework to respecting the privacy expectations of stakeholders has not been examined. The goal of this paper is to examine how privacy norms develop through social contract’s narrative, to redescribe privacy violations given the social contract approach, and to critically examine the role of business as a contractor in developing privacy norms. A social contract narrative dealing specifically with issues of privacy is an important next step in exploring a social contract approach to privacy. Here, the narrative is used to explain to analyze the dynamic process of privacy norm generation within particular communities. Based on this narrative, individuals within a given community discriminately share information with a particular set of obligations in mind as to who has access to the information and how it will be used. Rather than giving away privacy, individuals discriminately share information within a particular community and with norms governing the use of their information. Similar to contractual business ethics’ impact on global commerce in explaining how and why norms vary across global contexts, the social contract approach to privacy explains how and why norms vary across communities of actors. Focusing on agreements around privacy expectations shifts the responsibility of firms from adequate notification to the responsibility of firms as contractors to maintain a mutually beneficial and sustainable solution. (shrink)

Insurance fraud and abuse—international concerns—are inherent in the proposition of insurance and prevalent in insurer–insured interactions. While the subject of considerable industry and regulatory attention, this little-researched area of consumer behavior and consumer ethics represents persistent social policy questions and problems at multiple levels. This article addresses the issue by first defining insurance fraud and its origins in contract, as well as consumer- and insurer-management. The authors conclude by re-envisioning the problem as one of co-creation by the consumer-insured and insurer (...) personnel, proposing a framework for its study and resolution. (shrink)

Each state’s Medicaid Fraud Control Unit prosecutes billing fraud cases against individual healthcare providers who fraudulently bill Medicaid for services provided. Once an individual is convicted of billing fraud, the Office of Inspector General for the Department of Health and Human Services may exclude the individual from billing any federal government healthcare program, including Medicaid. Excluded individuals are added to a public list of exclusions, which restricts their ability to practice professionally. Prompted by criminology research into the impact of policing (...) resources, we test whether these government enforcement initiatives against fraud serve as a deterrent to would-be fraudulent billers. We document that key enforcement proxies, the staffing level and budget of an MFCU, are positively associated with the yearly number of exclusions added at the state level. Our results are consistent with the exclusion list not being a deterrent but provide support for MFCUs’ fraud detection efforts. This paper provides industry-specific fraud insights for auditors and other individuals involved in public policy, specifically Medicaid, and introduces a novel dataset to the accounting fraud research literature. (shrink)

A growing literature has focused on understanding how to detect and deter unethical consumer behavior. In this work, we focus on a particularly important type of unethical consumer behavior, consumer insurance fraud, and we analyze a unique dataset to understand how experts investigate suspicious claims. Two separate but related literatures inform the process of investigating suspicious insurance claims. The first literature is grounded in field research and emphasizes the importance of secondary sources. The second literature is grounded in laboratory studies (...) that emphasize the importance of interpersonal interactions. Here we draw upon both literatures to consider the importance of claimant interviews within the context of many investigative actions and the potential for claimants to avoid interviews. In an empirical study using qualitative and quantitative data from auto insurance claim investigations, we analyze investigative chronologies conducted by skilled experts. In doing so, we find that even when investigators can access information from a variety of sources such as witnesses, databases, and physical evidence, claimant interviews are the most important step in determining whether or not claims are denied or paid. Furthermore, we identify interpersonal avoidance as an important signal of unethical claimant behavior. Our findings inform deception detection theory and practice. We identify implications for deception detection in business, particularly for consumer unethical behavior and insurance fraud investigations. (shrink)