Winning the fraud game
Article Abstract:
Insurance companies must develop plans to discourage and detect fraud, which accounts for 10-20% of claim payments. To illustrate the industry's vulnerability, an analysis of the 'Casino Ring' case is presented. The perpetrators have the advantages of consistent stories, no witnesses and experienced professionals. Insurers must standardize effective anti-fraud claims adjustment techniques, such as enhanced interviews to uncover discrepancies and medical bill reviews to uncover exaggerations.
Publication Name: Best's Review Property-Casualty Insurance Edition
Subject: Insurance
ISSN: 0005-9714
Year: 1992
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Fraud battle paying off
Article Abstract:
The insurance industry is finding that forming or expanding a special investigations unit to detect fraudulent claims can yield financial benefits. CNA Insurance Cos. and Farmers Home Group save more money by pinpointing false claims than the companies spend on their investigations units. Insurers lose up to $120 billion a year to fraud, according to a Conning and Co. estimate. Prevention of false claims is becoming increasingly important as insurance profits tighten.
Publication Name: Best's Review Property-Casualty Insurance Edition
Subject: Insurance
ISSN: 0005-9714
Year: 1997
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Winning the fraud game
Article Abstract:
Techniques for detecting fraud in insurance claims are only as good as the degree of corporate support that is provided to adjusters. The key components of such support are: a system that rewards fraud detection; strong legal support; specially trained fraud investigators; expert systems; a quality control system that detects and eliminates defects in claims payments; and a system that effectively measures the incidence of fraud.
Publication Name: Best's Review Property-Casualty Insurance Edition
Subject: Insurance
ISSN: 0005-9714
Year: 1992
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Comment about this article or add new information about this topic:
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