Auto Accident Fraud: Investigation Guidelines


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After a report is received, GIA will review the information and evidence provided.

If the report has enough evidence to make out a case, GIA will send the details to the affected insurers to investigate, and co-ordinate cases involving more than 1 insurer. If the insurer s conclude that there is strong suspicion or evidence of fraud, they will report the case to the law enforcement agencies. The law enforcement agencies will investigate and prosecute the suspect where evidence has been made out.

Motor insurance fraud involves conspiring to make false or exaggerated claims involving property damage or personal injuries as a result of an accident. Insurance companies will strenuously investigate any suspicious motor accident claims and will not hesitate to escalate the matter to the Police.

In the event of an accident, video recordings often provide clear and objective evidence of circumstances leading to the accident, and can assist insurers to understand how the accident took place. In many cases, the settlement of insurance claims can be expedited when liability can be clearly determined from the recording.

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Furthermore, claims costs are likely to be minimised without the need for a lengthy investigation. More importantly, with timely and accurate information plus recording of the event, the opportunity for filing exaggerated and fraudulent claims is also minimised.


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Please inform the insurer of the vehicle which you are driving at the point of accident upon knowledge of any impending prosecution, inquest, fatal inquiry or offer of composition. If you have an outstanding mortgage loan with HDB or any financial institution, you are required to If you feel you have been treated unfairly by your insurer, you should lodge a complaint directly wi Motor Insurance Consumers Agents. A fraud squad team has the authority to assign cases to external investigators and engage legal department when needed.

In a broader level of insurance associations, or even big multinational insurers, staffing with ex-police officers is frequent.

What is insurance fraud?

However even if an insurer utilizes the best fraud detection system and has the best internal organization structure, again money can get out of the door and fraud savings can be minimized. Not only operational processes must be in place, but also automated controls powered by analytics and integration between related systems claims handling, underwriting, accounting, fraud detection etc.

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While applying a series of analytics techniques in a fraud detection process, via a hybrid score for every claim, and providing to the fraud investigator all needed data, so to visualize instantly cases that need high attention and to uncover hidden relations with social network analysis, enhancement of existing operational processes and applying automated controls is essential.

Specialized fraud prevention software and relevant project needs to provide such consulting service, as this will secure the best possible day to day fraud detection system utilization and maximize savings. This series explored 7 analytics best practices techniques that insurers need to follow for tackling auto insurance claims fraud.

Certifications - International Association of Special Investigation Units Inc (IASIU)

Stavros is an Information Technology senior professional since mid 90s, with great experience in the Business Intelligence and Analytics areas. Having previous roles of CIO, MIS Manager, Member of Strategic IT councils, Business Intelligence Consultant and working either in the software vendor side or inside large scale organizations, he has developed strong expertise in design and implementation of innovative Business Applications.

His managerial skills are focused in team leadership for inspiring teams to achieve any target. In the first six articles of the series we drilled down to: Data Management and Data Quality as the basis for fraud detection analytics.


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Business Rules and Watch lists techniques that play always a crucial role for claim handlers and fraud investigators. Advanced Analytics which add a layer of defensed towards the unknown fraud typologies that more experienced and organized fraudsters utilize. The most powerful advanced analytics technique of Social Network Analysis for uncovering hidden relationships between all involved parties and entities in a claims and not only process.

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Hybrid Scoring in order the insurer to be able to combine all of the above techniques and intelligence in a fraud risk scoring process. Legal department for advice or actions in complex situations.

Top 5 Insurance Fraud Fails

Internal investigation team usually very experienced claim handlers or supervisors. Accounting team for finalizing the payments. Policy management.

Auto Accident Fraud: Investigation Guidelines Auto Accident Fraud: Investigation Guidelines
Auto Accident Fraud: Investigation Guidelines Auto Accident Fraud: Investigation Guidelines
Auto Accident Fraud: Investigation Guidelines Auto Accident Fraud: Investigation Guidelines
Auto Accident Fraud: Investigation Guidelines Auto Accident Fraud: Investigation Guidelines
Auto Accident Fraud: Investigation Guidelines Auto Accident Fraud: Investigation Guidelines
Auto Accident Fraud: Investigation Guidelines Auto Accident Fraud: Investigation Guidelines
Auto Accident Fraud: Investigation Guidelines Auto Accident Fraud: Investigation Guidelines

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