Claims is arguably the most important of all insurance business processes.To a significant extent, claims recovery represents an unrealized opportunity for insurers, but opportunities for claims recovery are often obscured by the sheer volume of claims data available. Claims recovery analytics provides a win-win for the customer and the insurer.
Insurance companies and fraud-fighting agencies in North America are noticing a trend: Fraudsters are now exporting their best practices to our neighbors to the north.The province of Ontario has a mixed no-fault and tort insurance system with superb benefits that fraudsters are capitalizing on. Read this post by James Ruotolo to find out how insures to the north are battling this influx.
The primary benefit of an improved claims recovery process is the impact to your bottom line, but a truly great secondary benefit is the positive affect on customer satisfaction. Read Stuart Rose’s post about optimizing your claims recovery process.
The IRC has identified expensive diagnostic procedures as “major drivers of overall medical costs in auto injury claims.” These drivers can help fuel medical mill scams and make it difficult to differentiate between suspected fraud and suspected medical billing abuse. Scams such as these are putting pressure on legitimate providers to remain competitive. James Ruotolo has some advice for insurers and medical providers.
The recent proposal to extend the deadline for Solvency II compliance by one year reflects the finding of a report by the Financial Services Authority that many insurers are not ready to meet the standards. This extension can be veiwed as an opportunity to knuckle down – if you have the correct tips and tools. Here is some advice and a link to a white paper identifying six key challenges that must be addressed to meet Solvency II standards.
The Insurance Information Institute estimates that 10 percent of all property and casualty claims are fraudulent. Investigating suspicious claims after they are paid makes it so much harder for insurers to stop the fraudsters. In this post, Rachel Alt-Simmons reports on a panel discussion between Allstate and CNA, insurers that are now using data-driven decision making to detect and prevent fraud.
One way to reduce claims expenses is through claims recovery, unfortunately opportunities for claims recovery are often missed. Find out how you can minimize the number of missed recovery cases so you can increase efficiency and reduce loss expenses.
Given the increase in fraudulent claims, it is imperative for insurance companies to leverage technology as a key enabler to combat crime-ring-based fraud. Read this article to learn why predictive analysis is important for insurance fraud protection.
It will be many years before the Dodd-Frank Act has been deemed a success or just another compliance burden. Read about the role of the Federal Insurance Office and its potential for streamlining rules and regulations for insurers.
Events of the past decade have highlighted insurers’ need to evaluate the impact of operational risks. Rachel Alt-Simmons gives examples of insurers that have not adequately protected themselves from disaster or loss. Read what you can do.
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Turning a cost center into a money generator
Attending the ACFE Fraud Conference and Exhibition?
Plan to attend Increasing Investigator Efficiencies
When: Wed., June 30, 8:30-9:50a.m.
Where: Orlando, FL
Featuring: David Stewart and Dan Barta from SAS’ Fraud and Financial Crimes Practice.
Organized fraud is a growing problem, in large part because it is so hard to detect. In this session, we will show customer examples of how Entity Link analysis improves investigator efficiency by reducing the time spent investigating false-positive alerts and prioritizing events before presenting to investigators. Investigators can now work many times the number of cases and focus on higher-value networks.
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