Title:
INTEGRATING FORENSIC ACCOUNTING AND DIGITAL TECHNOLOGIES FOR RISK DETECTION IN HEALTHCARE AND LIFE INSURANCE: EVIDENCE FROM ALBANIA

Authors:
Fatmir Bërdica, Assoc. Prof. Mirela Miti (Ujkani) PhD and Jona Kastrati

Abstract:
This study examines the role of forensic accounting as a preventive mechanism for identifying financial fraud risks and strengthening good governance through the integration of digital information technologies in two high-risk sectors: life insurance and healthcare clinics. In the context of Albania, the role of forensic accounting has become increasingly significant, given the ongoing reforms in the insurance market and healthcare sectors, as well as the need to align with international accounting and transparency standards. The study’s methodology is based on a descriptive and comparative analysis, combining financial statement analysis with forensic accounting tools to identify risk through the detection of red flags. The research applies a Red Flag Index constructed on key indicators of liquidity, profitability, capital structure, and leverage to assess exposure to financial risk in four private clinics and in the health insurance sector over the period 2020–2024. The analysis is further supported by an examination of the legal and regulatory framework in Albania, as well as the market data. The results indicate significant differences in financial performance and risk levels among the clinics. The findings suggest that integrating forensic accounting techniques with digital technology enables the early detection of financial anomalies, enhances internal control systems, and supports decision-making processes in the life insurance and healthcare sectors

Keywords:
Forensic Accounting, Red Flag Index, Health Insurance, Services, Information technology

DOI:
https://doi.org/10.37500/IJESSR.2026.9310

Date of Publication: 24-05-2026