loading
The latest developments across the P&C insurance industry regarding fraud, risk and compliance.
09 June 2017

5 Reasons Why Insurers Should Start With Automated Fraud Detection

The shift to digitization is real. Across the globe, insurers are modernizing core systems, starting online channels and replacing manual tasks for automated ones. From a consumer perspective, there are a number of requirements that insurers should take into account. Those range from speed of service, via a fully digital experience, to seamless integration of products. Thus, bringing in new risks to cope with. The internal process changes, as well as the way insurers look at fraud management (fraud detection and fraud prevention). Automating fraud detection is key. And organizations need to orchestrate this properly. There are 5 reasons why insurers should start with automated fraud detection:

1. Increase the chances of detecting fraud and limiting false positives

automated fraud detectionWhen detection methods are automated and standardized, the chances of detecting fraud are increased and false positives are limited to a minimum. Fighting fraud can be a time consuming and error prone process. It absorbs time from people. They should work on customer satisfaction or investigate just those cases with the highest fraud probability. Money will flow to claims that are valid, saving the organization and customers from the costs of fraud. Eventually the loss ratios will drop as well.

2. Claims automation; Enable straight-through processing (STP)

Leverage the advantages of STP. It is virtually impossible to screen all incoming claims manually. Let alone to keep up with high and constant changing compliancy standards. Automating the process by scoring screenings via a predefined model helps. The claims that score below a set benchmark can immediately be paid out. Only claims that score above the benchmark need to be looked at. This could be done by either senior claim handlers or by a member of the Special Investigations Unit. Automated tools will leave less room for fraud. Also, they potentially enable a 100% STP of claims and policy applications.

3. Fraud management: Create more efficient fraud investigations

The-Top-5-Advantages-of-automating-fraud-detection-challenges-1By directly recognizing claims that need further attention or require active follow-up, organizations with automated fraud detection solutions are more effective at fraud investigations. Because the correct information is handed over to the fraud investigators. They can spend their time on cases that actually require attention. Fraudsters will receive a hard time, as the case against them can be built effectively. It gets even better when all information can be stored in a controlled environment like a fraud pool. This might enable the sharing of claims and fraud data with other insurers. Via cooperation insurers are able to work together in preventing fraudsters from hopping from one insurer to the other.

4. Objectify screenings

Data of investigated claims is often based on investigations that have not been carried out at random. There was always a reason, feeling, or indication for starting an investigation on certain cases. Such a feeling might be valid. Although there is a chance that one has searched for the justification of a preconception. Nowadays, more and more techniques are developed to detect unwanted biases. With an automated system, the influence of bias and/or prejudice when investigating data is limited. This will improve the quality of analyses. Thus, the managerial decisions that are based on them will be better.

5. Leverage information from the claims process to make better underwriting decisions.

The-Top-5-Advantages-of-automating-fraud-detection-challenges-2Often, precious time gets lost when people in the claims department need to constantly ‘mop the floor’. When fed back into the organization, data from the claims process could be quickly analyzed and compared with information of new applicants. Combining these two processes gives a strong estimation of the applicants’ potential future behavior. When risk analyses are already implemented in the underwriting phase, it is possible to stop fraud ‘at the gate’. High risks can either be stopped from entering the portfolio or they might receive risk-based pricing. Especially for an online channel, automating the underwriting efforts brings significant benefits.

Automated fraud detection; Embrace digital

These 5 challenges are only a high-level indication of what can really be done when automating fraud detection and risk assessment. The good thing is, starting with automation does not mean that other processes need to be paused. There are a few out-of-the box systems that can be up-and-running within weeks. Effective fraud fighting is at hand. With just a little help from smart software, insurers can focus on healthy portfolios and happy customers. As long as they are willing to embrace digital and innovative technology.

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
Utrecht

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.

Newsletter

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.

 

Subscribe