In order to apply force to far-reaching and ever-evolving schemes, insurers will also need to overcome some substantial impediments to investigation. Anthony Roman, head of global security and risk-management firm Roman & Associates, outlines 10 key obstacles that require careful consideration:
1. Inadequate resources. Generally speaking, the number of special-investigative personnel and support services is limited. Moreover, the flat-rate structure for investigation vendors can often lead to low-quality personnel and low-quality results
2. Inadequate prosecutorial and law-enforcement resources. If prosecution of insurance-fraud cases is minimal, then deterrence will be equally minimal. The issue of inadequate resources varies from state to state, but one common problem is that there are high monetary thresholds for district attorneys to accept—and be willing to prosecute—an insurance-fraud case. For example, some prosecutors may not be interested unless there is a loss of $100,000 or more.
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