Industry leaders specialising in fraud identified the current home working recommendations, introduced by the government to mitigate the coronavirus outbreak, as a “real threat” because it increases the opportunities for insurance staff to commit fraud, or for employees to fall victim to fraudsters and enablers.

Katie Scott Insurance Times 18 May, 2020

Link to full article below.

It helps if your digital claims management software is optimised for both WFH and Claims Call Centre models. And that there is a single digital record for all stages of a claim giving a single and updated version of the truth with every task, interaction, communication, event and upload/download time and date stamped : -

  • FNOL
  • Assignment
  • Investigation
  • Evaluation
  • Case Reserving
  • Fraud management
  • Negotiation & settlement
  • Payments
  • Recovery

A single digital record that can be shared securely with all the parties involved in a claim both internally for the insurer and externally with the supply chain and partners.

To counter the threat identified in the Insurance Times article you will want your technology partners to help you access all the data you need. That must include all the unstructured data that is typically hidden in silos. Many claims leaders must be frustrated that the unstructured free-form data in claims notification forms is so hard to analyse. In fact typically not analysed at all.

Hidden here are the clues to fraud which once accessed are revealed by solutions like 360Retrieve. Then there is all the data in the daily volume of correspondence and reports that hit an insurer.Being able to access, machine read and analyse these is essential to identifying fraud.

Once your technology partner helps you do that there is the matter of joining all this data up and combining it  with external data sources like Synectics. 

By that stage you will be gaining from the classic 360 degree view of customers, claims and potential fraud. Whether your claims team is operating on a WFH model, back at claims offices or operating a mixture of the two your claims management platform should be up to the job of helping you manage fraudulent claims and internal fraud effectively.

Elementary dear Watson!