Anyone in the insurance industry knows that fraudsters are becoming more sophisticated and their crimes more difficult to identify. Insurance fraud in the UK costs an estimated £3 billion per year – but only around a third of that is detected. Whilst opportunistic fraud poses a problem to the industry and
See how analytics fights back against ever-changing fraud trends.
This is the fifth of the seven parts of blog post series “A practical guide to tackle auto insurance fraud”. In the first four articles of the series we drilled down to Data Management and Data Quality as the basis for fraud detection analytics, to Business Rules and Watch lists
In the first three articles of the series we drilled down to Data Management and Data Quality as the basis for fraud detection analytics, to Business Rules and Watch lists techniques that play always a crucial role for claim handlers and fraud investigators and to Advanced Analytics which add a
Criminal enterprises are tapping into the lucrative opioid business through creative schemes that are less likely to be identified as opioid abuse, misuse or diversion. One of the latest schemes? Auto insurance fraud. First, some background… While extensive progress has been made in establishing, improving, and mandating prescription drug monitoring
The technology breakthrough during the last years have brought an increase in insurance fraud and, as a consequence, they are changing the landscape in the sector. From Pricing Comparison Websites (aggregators), to Telematics and Usage Based Insurance, to Internet of Things, the increasing demand for Cyber Insurance and new Peer
Over the years I have written many blogs about insurance fraud including those on anti-money laundering, data quality in fraud, anti-fraud technology, life insurance fraud and even ghost broking. It’s clear that insurance fraud comes in many shapes and sizes and as losses continue to grow, detecting and preventing fraud
Over the past decade in insurance, the rise of the aggregators (organisations that compare quotes between different insurers) and direct channels has had a profound impact on personal lines distribution in the UK. However, personal lines brokers remain a critical route to market, especially at a time when many insurers
Another day, another scam defrauding insurers and governments. For purposes of full disclosure, the case I'm highlighting today comes from Washington's Labor and Industries (L&I), the agency where I formerly worked and headed up fraud prevention efforts, and the investigation dates back to my time there. During my time there,
Personally, I love studies. They help put things into context, and when done well, provide an independent and hopefully unbiased view of the forces that shape our lives. They are also a great way to see government funds used in strange ways. For example, the new NIOSH (National Institute for
In the health care field, the impact of fraud, waste and abuse on payers -- whether insurance companies, government agencies or self-insured employers -- is enormous. Fraud losses weaken a payer’s financial position, with fraud loss estimates rivaling net income. Fraud losses feed the escalating care cost curve, undermining a
This year, SAS joined the Coalition Against Insurance Fraud (CAIF). Not long ago I had a chance to attend my first CAIF meeting and I was very impressed with what I saw and heard. Fraud continues to be a thorn in the side of the insurance industry. The most recent
Unemployment Insurance, mandated by federal statute and administered by states, is designed to provide a temporary safety net for workers who lose their jobs. Due to the recent economic downtown and increase in unemployment, unemployment benefits paid have doubled nationally from $38B in 2008 to $75B in 2009. However, is
