In 2022 in France, 20% of French people assume that they have defrauded their insurance According to Le Dauphiné. However, insurance fraud is still very difficult to detect. It is therefore recommended for insurers to put in place an anti-fraud policy. but what strategy should be adopted? What are the different ways to effectively combat document fraud? We give you our advice!
Why develop an anti-fraud insurance strategy?
The fight against fraud is a global struggle. Indeed, in addition to affecting insurers, fraudsters also have an impact on policyholders more generally. Insurance companies must therefore ensure that fraud does not impact their business, their profitability but also their customers.
Thus, fighting fraud has several main objectives:
- Protecting honest policyholders
- Reducing costs associated with claims
- Optimizing profitability Of his business
- Improve the customer satisfaction
- Strengthen the competitiveness Of his business
Once these goals are set, you need to ask yourself the right questions in order to fight effectively. We give you a few examples so that you can see it a little more clearly: what tools can you put in place to strengthen the fight against fraud? What are the main vectors of fraud in the insurance sector? How to effectively make teams aware of the techniques used by fraudsters? What strategic approach should your business take to proactively counter fraud?
Once the questions have been asked, it's time for you to move on to implementing your anti-fraud policy! We'll tell you more later in this article.
Anti-fraud policy, advice number 1: secure your contracts
When your customers sign up for contracts, be sure to fill out the paperwork carefully. Indeed, a contract offers you protection against the various types of fraud. To do this, we recommend two main strategies!
Integrate specific provisions
To protect your business from fraud risks, you can integrate specific clauses to the contract you enter into with your customer. For example:
- Of late payment periods
- Of annual repayment limits
- The late payment in case of suspicion of fraud
- The framework for the fight against fraud and the existence of a Watchlist
Enforcing sanctions
In order to best combat insurance fraud, it may also be interesting to apply sanctions in case of non-compliance with contracts ! In particular, we think:
- Au reimbursement of undue amounts
- A la rTermination of non-respected contracts
- At the commitment of criminal prosecutions
These sanctions make it possible to deter fraudsters in their fraud attempt!
Anti-fraud policy, advice number 2: monitor the fight against fraud
To fight effectively against fraud, the best thing is to sharing its techniques and its approach. Indeed, the sharing of information and best practices makes it possible to stay informed and to be up to date with the latest developments in the sector.
To help you in this fight, you can get closer to the Agency for Combating Insurance Fraud (ALFA). Its role is to promote the fight against insurance fraud and to provide support to insurers. It makes it possible to provide real support to different types of people:
- For the underwriters, it raises awareness about The importance of good practices and actively encourages the information sharing regarding questionable behavior.
- For the professionals, it promotes respect for good practices and encourages collaboration in the fight against fraud.
Anti-fraud policy, tip number 3: install regular checks
The fight against fraud involves the omnipresence of controls. It makes it possible to avoid investigative costs, legal fees and legal fees for small undue amounts and to manage reputational risks.
Several means are at your disposal to fight effectively:
- Manual control, which consists in checking each supporting document by hand
- Control via a watch list, it allows you to check the documents of customers suspected of having already defrauded
- The analysis of documents with large refunds which allows you to check the amounts of major claims
💡 Did you know?
Combining business and the fight against fraud is not contradictory, quite the opposite!
To learn more about how you can capitalize by fighting document fraud, go to our dedicated article: The fight against fraud and business, how to combine them?
Anti-fraud policy, tip number 4: use analysis tools and artificial intelligence
Insurance fraud occurs in a variety of ways and is quite deceitful. For this, you must use all the means at your disposal to fight against. How? By implementing a combinatorial detection approach.
You improve the quality of services in terms of procedures and claims management and you create a stronger customer relationship.
At Finovox, we have developed a SaaS solution available via an API, designed to analyze documents by detecting any possible alteration. How does it work? It uses several algorithms, including coherence analysis, visual, statistical and computer analysis.
As an insurer, all you need to do is upload your policyholders' documents into our solution. They are then screened to determine if they are authentic or if they have been manipulated to obtain undue payments. If alterations are detected, we provide you with a detailed report on the falsified areas as well as on the fraud methods used.
With Finovox, explore all your documents, regardless of their type or language! Interested in our solution? Do not hesitate to ask our experts for a demonstration!
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