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The latest insights on fraud, risk & compliance: 'fresh from the FRISS Lab'
27 November 2017

Creating a Fraud Fighting Culture

Welcome to another episode of FRISS Lab. Sometimes we see big differences in results between our customers and that’s strange: they all use our software solution. So today we visit our CCO Marc Mulder. He will answer the following question: how do you create a fraud fighting culture and align your KPIs accordingly?

Hi guys, have a seat!

I visited several insurers in the last couple of months and I found a huge difference between the one that is successful in finding fraud and the one that is less successful.

What’s the difference?

The main difference, the word that keeps running in my mind, is a fraud–fighting culture. They all have this automated detection system but not everybody has a fraud–fighting culture.

A Fraud–fighting culture, what’s that?

Exactly. Difficult to pinpoint but what it comes down to is they do a few things really well.

  • They have aligned KPIs,
  • Senior management is really involved…
  • And there are a lot of trainings, sometimes up to four times a year.

In general, when it comes to KPIs you see claim adjusters are measured on speediness of handling a claim and on customer satisfaction. If you also have the KPI of trying to find fraud, how well you do that it means, you have to ask additional questions in the process with the customer. That clashes with other KPIs. If you align those, you can achieve a lot.

You mentioned some other points as well?

Other points are involvement of senior management which means they get on the floor, they praise the ones doing a great job, in actually fighing fraud. They feed the fraud–fighting culture which is really important. And the trainings. They have learnings, share it with each other. New people get on board, get them to the right level immediately. Those things. A fraud–fighting culture is not just an automated system. It’s also the organisation around it.

Can you give an example?

Yes. One example is a company that actually saved 1.1 million dollars within 7 months. And everybody is focused on doing this. It does not have a bad influence on the other KPIs, so there is still high customer satisfaction. And still a very good handling time of claims.

So, what’s your main conclusion?

My main conclusion is that next to having an automated detection system in place it’s important to have a fraud–fighting culture. If you have that and you have both, you’re going to be able to save a lot of money but you’re also going to be able to actually make insurance a bit more honest.

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