External Fraud Risk Management seen from Luhmann’s Systemic Perspective and a Tentative Reading of Healthcare Insurance Companies’ Measures through this Perspective

This research explores the contribution of Niklas
Luhmann’s radical systemic sociology to External Fraud Risk
Management. To do this, we use two Luhmannian distinctions —
between risk and danger, and between confidence and trust — to
verify their (in)validity based on two empirical studies on
Healthcare Insurance Companies (HIC) to reduce the risk of
external fraud. This study concludes that the Luhmannian
framework is relevant for external fraud management issues.