Key speaker - Tim Richardson, Director of Investigation Operations, Direct Group.
We were delighted to attend a seminar yesterday afternoon in Bradford, presented by Tim Richardson from Direct Group, where he gave a great insight in to how fraud is detected within the insurance industry.
Tim began his insurance career in 1986, starting as a Claims Handler, progressing to a Loss Adjuster and latterly moving into senior management positions. Whilst detecting fraud has always been part and parcel of Tim’s career, his last few appointments have purely been focused on the investigation of fraudulent activities.
Tim is an impressive individual and more than qualified to deliver a seminar on fraud detection – in fact, he is the only person in the UK to be accredited with ACII, ACILA and ACFS. Well done Tim!
As I am sure you won’t be surprised to hear, fraud is on the increase, whether this is from policyholders exaggerating genuine claims, opportunists spotting potential ‘quick wins’, crash for cash exploits, as well as an increasing number of claimants who are reporting made-up losses due to their financial difficulties.
Some cases are straight forward and are swiftly quashed, however many require in-depth investigation. During the lecture, we heard some highly amusing stories about the great lengths that some (anonymous) claimants had gone to in order to concoct plausible (or should I say highly implausible!) stories surrounding their claims. Detection of fraud is definitely an art form; it can be challenging and frustrating, even when there are no doubts that the policyholder is being dishonest, because without sufficient proof or evidence, opinions don’t count. It is imperative that all the correct processes and procedures are adhered to, ensuring that the investigation is water tight and statements are signed. We learnt of a number of interesting and varied indicators that can be used to detect fraud, which include analysing body language and natural reactions such as blushing, change of vocal tone/pitch, hesitation, or avoiding difficult subjects when questioned. We automatically have an emotional connection to stories that are true - we reflect on memories and visual images, which allow us to provide real detail on not only the loss, but the environment/surroundings we were in at the time. When claimants are lying, obviously they don’t have these emotional connections to relate to, which is how stories can spiral out of control and holes begin to appear in their original statements.
In the last ABI report which was issued in 2011, there were 71,000 dishonest Household claims and 45,000 dishonest Motor claims. The final figures for 2012 will be issued in September 2013. People like Tim and his team are saving insurers millions of pounds a year!
If you would like to review the presentation, or make an enquiry as to how Tim and his team can help your business, please feel free to contact him directly on: 07557567013 or firstname.lastname@example.org