Insurance Fraud Identification
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- Harriet Wright
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1 Insurance Fraud Identification The UK Perspective 4 December 2013 Key contact: Michelle Reilly Client Development Manager Michelle.reilly@weightmans.com
2 Overview The scale of the problem UK organisations combating fraud Intelligence sharing Types of fraud Organised fraud Opportunistic fraud Solutions Conclusions 2
3 The scale of the problem in the UK Detected fraud topped 1bn in UK this year Undetected fraud is estimated at 2bn is added to motor premiums to counteract the effect of fraudulent claims Not limited to motor claims A compensation culture No statutory definition of fraud Inconsistent decisions from the courts Punishment only in exceptional cases
4 UK organisations combating fraud Insurers have set up specialist anti-fraud teams incorporating analytical and risk assessment tools to help identify fraud; Insurance Fraud Bureau (IFB) set by and funded by insurers to centrally fight organised fraud Insurance Fraud Enforcement Department (IFED) established in January 2012, specialist police unit, funded by ABI/Insurers focused on insurance fraud Insurance fraud Investigators Group (IFIG) Insurance Fraud Register (IFR) 4
5 UK Intelligence sharing Intelligence led alerts are issued frequently by IFB, IFIG, and the specialist fraud teams of legal firms Data sharing, data washing and data mining using products such as CUE, MIAFTR, SIRA, and Detica NetReveal Exchange of information and data is controlled by Data Protection Act 1998 which allows a reasonable working exchange under Section 29(3) when fraud is being investigated
6 Types of fraud in the UK Staged accidents cash for crash Contrived accidents Low velocity impact Ghost passengers Exaggerated/fake credit hire claims
7 UK focus on organised fraud - IFB IFB funded on a voluntary basis by the majority of insurers NetReveal database continuously auto mining market data to highlight potential organised fraud rings Fraud analysts assess the output and assess need for further research and investigations Continual liaison between IFB and insurers on alerts, intelligence, requests for investigations, trends, hotspots This information can be shared with other interested parties, e.g. lawyers, investigators and loss adjusters. IFB Consolidate intelligence to present to law enforcement and regulatory bodies 7
8 UK insurers focus on opportunistic fraud Fraud awareness training for all handlers Use of fraud indicator checklists Specialist anti-fraud teams Use of industry wide databases to identify Serial claimants Known fraudsters Suspect entities 8
9 Solution to the fraud problem in the UK Legislative changes imposed in April 2013 Publicity campaigns Shift in public perception Whiplash Consultation Law Commission Consultation on fraud Better intelligence sharing Penalties for fraudsters/sentencing guidelines under review
10 Conclusions Fraud is a complex issue in the UK Too early to assess if the legislative changes imposed in April this year are having an impact UK doesn t have all of the answers but a combination of training, investment, sophisticated detection tools, new initiatives, and cooperation between insurers and law enforcement agencies means that we are beginning to win the fight against fraudsters.
11 Questions? 11
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