What insurance anti-fraud policy should be put in place?

In 2022 in France, 20% of French people admit to having defrauded their insurance company according to Le Dauphiné. However, insurance fraud is still very difficult to detect. It is therefore advisable for insurers to put in place an anti-fraud policy. But what strategy should they adopt? What are the different ways of effectively combating fraud? document fraud ? Here's our advice!

Why develop an anti-fraud insurance strategy?

The fight against fraud is a global fight. As well as affecting insurers, fraudsters also have an impact on policyholders more generally. Insurance companies must therefore ensure that fraud does not have an impact on their business, their profitability or their customers. 

The fight against fraud has several main objectives: 

• Protecting policyholders with integrity 
• Reducing costs associated with claims 
• Optimising profitability of his company  
• Improving customer satisfaction 
• Strengthening competitiveness of his company  

Once these objectives have been set, you need to ask yourself the right questions in order to fight fraud effectively. Here are a few examples to help you see things a little more clearly: what tools can you put in place to step up the fight against fraud? What are the main vectors of fraud in the insurance sector? How can you make your teams more aware of the techniques used by fraudsters? What strategic approach should your company adopt to counter fraud proactively?

Once the questions have been asked, it's time to put your anti-fraud policy into practice! We'll tell you more in the rest of this article. 

Anti-fraud policy, tip number 1: secure your contracts

When your customers take out contracts, make sure you fill in the documents carefully. A contract offers you protection against different types of fraud. To do this, we recommend two main strategies!

Incorporating specific provisions 

To protect your company from the risk of fraud, you can incorporate specific clauses the contract you enter into with your customer. For example: 

• From payment default periods 
• From annual reimbursement ceilings 
• THE delay of payment in the event of suspected fraud
• The framework for the fight against fraud and the existence of a watch list

Applying penalties 

In order to combat insurance fraud as effectively as possible, it may also be worthwhile to apply penalties for non-compliance with contracts ! We're thinking in particular of : 

• Visit repayment of undue payments
• A la rTermination of unfulfilled contracts
• To the commitment of criminal proceedings

These penalties are designed to deter fraudsters from attempting to commit fraud! 

Anti-fraud policy, tip number 2: monitor the fight against fraud 

The best way to combat fraud effectively is to share techniques and approaches. Sharing information and best practice means that you can stay informed and keep abreast of the latest developments in the sector.

To help you in this fight, you can get in touch with the Insurance Fraud Prevention Agency (ALFA). Its role is to promote the fight against insurance fraud and provide support to insurers. It provides real support to different types of people: 

• For the subscribersIt raises awareness of the importance of good practice and actively encourages information sharing about questionable behaviour.
• For the professionalsIt promotes compliance with good practice and encourages the collaboration in the fight against fraud.

Anti-fraud policy, tip number 3: set up regular checks 

The fight against fraud means that controls are ubiquitous. This helps to avoid investigation costs, legal and court costs for small amounts of undue payments and to manage reputational risks. 

There are a number of ways you can take effective action: 

• Manual control, which involves checking each supporting document by hand
• Control via a watch listIt can be used to check the documents of customers suspected of previous fraud. 
• Analysis of documents with large repayments to check the amounts of major claims  

Anti-fraud policy, tip number 4: use analysis tools and artificial intelligence

Insurance fraud takes many forms and is quite devious. So you need to use all the means at your disposal to combat it. And how do you do that? By implementing a combinatorial detection approach. 

You'll improve the quality of service in terms of procedures and claims management, and build stronger customer relationships.

At Finovox, we have developed a SaaS solution available via an API, designed to analyse documents and detect any possible alterations. How does it work? It uses a number of algorithms, including consistency analysis, visual analysis, statistical analysis and computer analysis.

As an insurer, all you have to do is upload your policyholders' documents to our solution. They are then screened to determine whether they are genuine or have been manipulated to obtain improper payments. If any alterations are detected, we provide you with a detailed report on the falsified areas and the fraud methods used.

With Finovox, explore all your documents, whatever their type or language! Interested in our solution? Ask our experts for a demonstration!