Filed Under:Claims, Investigative & Forensics

Best Practices To Bolster 'Fraud Intelligence’

P&C insurers must contend with conflicting priorities, such as fostering company growth while thwarting fraud that invariably tugs at the bottom line. Moreover, the very mechanisms that help drive progress—including mobile technology and data-rich social media—present unique challenges and added vulnerabilities to emerging fraud schemes. In some ways, data is both insurer friend and foe, enabling ever-enterprising criminals to execute their scams.

Such is the dilemma Forrester addresses in its new report, “Prevent Insurance Crime With The Four Cornerstones of Better Fraud Management.” According to the Cambridge, Mass.-based independent research and data analysis firm, insurers certainly have recourse, one that requires a fundamental shift in the way in which they view business.

In the current “age of the consumer,” insurers tend to view SIU organizations as an expense overshadowed by customer satisfaction goals, Forrester asserts. However, “fraud intelligence” is a critical component in “business intelligence,” and getting smarter relies on a proactive, multi-faceted approach to both detecting and deflecting fraud.

Drawing from interviews conducted with analytics vendors, SIU department heads and data experts during the second quarter of 2012, Forrester outlines four core strategies in addressing the insurance fraud conundrum:

1. Rethink SIU teams.

2. Establish standard metrics.

3. Use mobile applications everywhere.

4. Improve data quality and increase data quantity.  

The firm expounds upon these concepts and other weapons in the insurers’ anti-fraud arsenal, including effectively coupling predictive analytics with business intelligence strategies to enable early, swift detection. For more information or to purchase a copy of this report, go to www.forrester.com.

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