The latest thinking and expert insights into the insurance industry.
13 January 2017

The fast changing role of fraud coordinators and investigators: ‘Adieu Poirot, welcome CSI!’

Gerwin Marskamp has years of experience working as a fraud investigator and fraud coordinator at Achmea. Since 2016 he is Business Owner SIU / FraudPool at FRISS.  His field is undergoing a much-needed transition. The ongoing digitization in combination with the increased influence of the investigator play an important role in this.


The digitization of the insurance world is here to stay. Humans are disappearing from many processes and with them the personal check on potential misuses. Fraudsters are eager to use the ‘anonymous space’ this creates. It no longer concerns a secretly altered receipt of an opportunistic fraudster. Committing fraud in the digital era is easier, it does not take much notice of national borders and is therefore very attractive for organized crime.

This development requires an entirely different approach: fraud prevention by teams of experts that employ all the options this digitization offers (legally). As a result, an essentially different role – or mindset – for fraud investigators and coordinators is needed. Those who commit fraud digitally need to be recognized and dealt with digitally.

Rarely an isolated case

Investigating specific fraud cases – at the request of the claims department – will for the time being continue to form the majority of our work. But how unique are these cases? Does the work end after a case is closed? As far as I am concerned, it does not. Maybe that specific case is a good reason for data analysis of similar cases. If one fraudster uses a specific method, no doubt others will do the same. For example, if after the death of an insured one family has continued the benefits abroad, then it is fairly simple to check the situation of other elderly insured persons in similar countries. Questions like this need to be asked and systematically examined.

Analysis based on specific indicators is effective as well. Take for example the time between taking out insurance and making the first claim. Or the number of cases of vehicle damage around midnight when there are likely to be few witnesses and the use alcohol might be involved. Many cases are predictable. The information is available, so make sure you use it!

Stronger together against fraud

Tracking down and preventing organized fraud requires collaboration. For example, this type of fraudsters often targets more than one insurance company. Thus, the public interest in fraud prevention goes beyond the interests of individual organizations. It is therefore in everyone’s interest that these barriers are brought down.

This may also lead to the ‘translation’ of investigated fraud scenarios into insurance policies and claim forms. This makes the loopholes in the rules smaller and reduces temptation.

Digitization: a concern and a blessing

Insurers invest a lot in automation, which has the great advantage that fewer, expensive, people are needed in order to take out insurance and the prices can remain competitive. The main disadvantage is the lack of human check; the ‘anonymous space’ fraudsters put to their advantage.

If identification is not needed in order to take out insurance, how do you know who you are really dealing with? The consequence might be that a dormant limited company takes out income protection insurance, providing the required minimum of data: the number of employees and the total sum of the salaries. Then, within no time, claims that these employees are sick come in one after the other. By the time the insurer gets suspicious, the limited company has gone bust and substantial amounts of money have vanished. A type of organized crime that is on the rise.

fraud-investigators-should-work-together-to-combat-insurance-fraud-in-the-digital-era-blog-gerwin-marskampPrivate persons abuse the absence of identification as well. There are numerous examples in which a person has taken out insurances with different companies under dozens of fake names in order to put in the very same fraudulent travel claim.

This type of offence needs to be combated with similar means, making maximum use of all digital options that are available. I would like to challenge insurers to explore the boundaries of the law (on privacy). Where those boundaries lie, differs for each country. In my opinion there is still plenty of leeway: do the messages the insured person posts on social media correspond with the information he or she gives to us? Does the insured have similar insurance policies elsewhere? Are a large number of insurances taken out on the same address, on the same zip code, or – very interesting – on the same IP address? At the moment we do not adequately act upon the latter.

As far as I am concerned, teams of experts could make a start with this. Teams consisting of various specialists with a background in ICT and data-analysis combined with seasoned experts in the field of interviewing and human contact. Investigators that keep their knowledge up to date and can adjust to the changing world of insurance. Experts that jointly set up knowledge bases and continue to keep on track with the ever-growing bulk of international data.

Human measure

There is a new a new role for fraud investigators/coordinators. They used to be all-rounders with broad knowledge and wide experience. Nowadays they are more and more specialists that work together on team projects. What they have in common is a sense for signals that might be indicators of fraud.

A large-scale search for unusual peaks in data is pretty straightforward, but filtering those peculiarities that are statistically and logically difficult to explain, is harder. This requires context, knowledge of digital manipulation techniques (e.g. in images), common sense and occasionally a confrontation with the suspect.

Aspirations and reality


Every year fraud costs insurers in the Netherlands an estimated 900 million euro, only a small part of this – 30 to 40 million euro – is ever proven. In other countries it will not be very different.

Given these figures, it does not take much for investing in fraud investigation to be worthwhile. Investing in training, in databases, in data-analysis and, in particular, in new experts. Collaboration will become an essential factor. The days of the independent investigator are over. The time has come for experts that work together on fraud investigations, led by experience and common sense. Poirot does not need to retire, but he does need to work in close collaboration with the experts of CSI.

Contact us

Cookie and Privacy Policy

1. Introduction

When you use this website, FRISS may collect information about your use of the website and the content offered. We believe it is important to handle your (personal) data with due care and confidentiality. When processing your personal data, we comply with the General Data Protection Regulation (Algemene Verordening Gegevensbescherming) and Article 11.7a of the Telecommunications Act (Telecommunicatiewet).

1.1.  Controller

The controller of the processing of personal data is:

FRISS Fraudebestrijding B.V.
Orteliuslaan 15
3528 BA

This processing of personal data is registered with the Dutch Data Protection Authority (Autoriteit Persoonsgegevens) in The Hague under reporting number m00004997.

1.2.  Purposes of data processing

There are several places on our website where you can fill in your (personal) data. We will explain the purposes of the various instances of data processing below.

Filling in the contact form or sending an e-mail

If you fill in the contact form on our website or send us an e-mail, we will only use the (personal) data you provide for the purpose or purposes for which you filled in the contact form or sent the e-mail.

Download form

If you download files on our website (such as e-books, whitepapers or reports), we will use the (personal) data you provide for one or more of the following purposes:

  • for the execution of an agreement, for example to send you the e-book, whitepaper or report you have chosen;
  • for the formation of an agreement, for example by contacting you by telephone or in writing.


If you fill in the application form for the newsletter on our website, your (personal) data will be used to send you the newsletter. Each newsletter contains a hyperlink at the bottom of the message that you can use to unsubscribe.

In addition to the personal data you provide to FRISS yourself, FRISS may collect, record and process additional (personal) data if you use the (web) services of FRISS. This concerns the following personal data:

  • data from the used equipment, such as a unique device ID, version of the operating system and settings of the device you use to access a service;
  • information about the use of a service, such as the time at which you use the service and the type of service that is used;
  • location details from your device or derived from your IP address that is provided to us when you use a particular service;
  • data available from external sources. We may receive information about you from public or commercially available sources.

1.3.  Provision of (personal) data to third parties

Your (personal) data will never be provided to third parties without your permission, unless we have an obligation to do so pursuant to legislation or regulations or you have given permission for this.

1.4.  Security of data

FRISS respects your privacy and ensures that personal data are handled confidentially and with the utmost care. All processed (personal) data is stored exclusively in secure databases. These databases are only accessible to employees of FRISS, to the extent that this access is required by virtue of their position. FRISS makes every effort to secure these systems against loss and/or any form of unlawful use or processing.

1.5.  Inspection, correction and deletion of data and the right to object

You can view your data that is processed by FRISS at any time and free of charge and, if you so wish, modify this data or have it deleted. You can also object to receiving information about products, services or content of FRISS. If you wish to make use of one of these options, you can send an e-mail to the Data Protection Officer of FRISS via privacy@friss.eu or write to the following address:

FRISS | fraud, risk & compliance
Attn. Data Protection Officer
Orteliuslaan 15
3528 BA Utrecht.

2. Cookies

When using this website, information about your use of these services and other websites may be collected by or on behalf of FRISS, for example by means of cookies.

A cookie is a small file that is sent along with pages of a website and stored by your browser on the hard disk of your computer. We use cookies to remember settings and preferences. You can disable these cookies via your browser.

2.1.  The purposes for which FRISS uses cookies

On our website we use cookies for the following purposes:

  • for statistical purposes, in order to analyse the use of FRISS websites. This allows us to keep track of the number of visitors and see which parts of our website are popular. We use Google Analytics in order to track and consult these statistics. On this website you can find explanations about all cookies that may be placed by Google;
  • for what is known as ‘targeting’ purposes, if you have used the download form. By targeting we mean building a profile of you based on your surfing behaviour on our website, after which we may contact you by telephone or e-mail based on the interests you have shown in order to offer you FRISS services that you may be interested in. We use HubSpot in order to track and consult these statistics. On this website you can find explanations about all cookies that may be placed by HubSpot;

3. Changes to this Cookie and Privacy Statement

FRISS may make changes to this Cookie and Privacy Statement. All modifications will be published on this page. We advise you to consult this Cookie and Privacy Statement regularly, so that you are always aware of the content of the current Cookie and Privacy Statement.