Presentation on theme: "Health check on Fraud Management within Insurance sector CILA Presentation by Anti-Fraud SIG John Freeman 30th October 2007."— Presentation transcript:
Health check on Fraud Management within Insurance sector CILA Presentation by Anti-Fraud SIG John Freeman 30th October 2007
Fraud and the insurance industry Research results January 2001 Professor Alan Doig and Professor Michael Levi Principle recommendations; Establish common definitions for fraud measurement Formal protocols with the police Public surveys Requirement and scoping exercise, undertaken across industry databases Create Industry wide fraud resource Information sharing protocols Increase professionalism within the investigation arm of the insurance industry
Common definitions for fraud measurement Response ABI definitions agreed and data being reported Three broad categories: Fictitious losses, incidents or injuries Staged incidents Material misrepresentation or exaggeration of losses or personal injury Returns based on: Proven insurance fraud Suspected insurance fraud
Formal protocols with the police Response ABI/ACPO Memorandums of understanding Version I & II Improved communication channel New fraud law will add weight? Renewed focus but resource issue needs to be tackled?
Public Surveys ABI Public surveys Focus Group sessions Commercial Fraud Survey Host of Industry Surveys
User requirement and scoping exercise to be undertaken ABI Polaris project Objective to develop common standards and common data access protocols Accessing CUE, MIAFTR,MID etc on one common platform Streamlined and efficient use of technology to deliver industry data requirements
Create industry-wide fraud resource Insurance Fraud Bureau Focus on distributed claims fraud, through which organised criminals make multiple, fraudulent insurance claims across many insurers. Detica under contract will apply a series of advanced, new data analysis techniques to detect patterns of fraudulent behaviour in huge volumes of claims data supplied to the IFB by UK insurers. £3.4 Million contract will be run as a managed service, Detica to supply fraud intelligence on an ongoing basis to internal team of insurance fraud case managers.
Agree information sharing protocols Insurance Fraud Investigators Group – committee role is to: Manage the circulation of intelligence to IFIG Members Consider revocation of a firm or individuals membership of IFIG where procedures are breached National Intelligence Model provides: Greater consistency of investigation across the UK Allows more investigators to focus on solving priority problems and targeting the most active offenders thereby reducing exposure Achieves greater compliance with human rights legislation and the Regulations of Investigation Powers Act (RIPA) Informs the management of risk Improves integration with partner agencies
Increase professionalism of investigators FSA Consumer protection Competency SIA Integrity Probity Competency CILA SIG Charter
Conclusion Substantial progress since original report in all areas Need to do more in the market to publicise the fact Must not become complacent Challenging times ahead Danger of compartmentalising strategy Holistic solution must be the end objective
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