“Insurance fraud is a continuous game of cat-and-mouse,” explains James Quiggle, director of communications for the Coalition Against Insurance Fraud (CAIF). “Investigators build a mouse trap, but then swindlers build a better mouse. The industry’s best defense is amassing field intelligence and analysis and then throwing that up against a ring.”

While detection and investigation have become far more scientific, the technology and methods are only as effective as those utilizing them. Staff must be apprised of proper data-mining techniques, and the insurer must be willing to cultivate a system-wide awareness of fraud at all levels of the company and programs for identifying and disseminating clues to the special investigative unit (SIU).

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