Effective combating of fraud by professional research and investigation
Insurance companies want to keep their customers satisfied by settling claims rapidly. It is however also in the interests of the customers for insurance companies, as the custodians of their premiums, to distinguish justified from unjustified claims. Causing estimated losses of around four billion euros each year, insurance fraud is a problem to be taken seriously by the industry.
The primary challenge for the claims and fraud departments is that of detecting cases of fraud. If there is a suspicion, background research, local investigation and questioning and the collection of evidence for possible court proceedings will in many cases be required.
EXCON’s national network of qualified investigators supports you effectively and systematically in the investigation of inconsistencies and the collection of evidence. Our investigators have many years of relevant professional experience and training in interview techniques, and become involved when there are firm grounds for suspicion or questions to be answered. Optimum data protection and confidential handling of sensitive, personal data are a matter of course for us. The technical systems at EXCON have been tried and tested in the banking sector over several years, and our internal auditing department ensures that the required standard is maintained.
Together with overt and covert investigation services in the claimants’ environment by our field operatives in the case of conspicuous claims under any type of policy, EXCON also supplies research services by specialized staff at our head office, covering all relevant social networks and commercially available databases.
Systematic fraud investigation in claims and fraud departments often fails due to lack of capacity, inadequate sources of information or internal corporate rules. A simple search in social networks, for example, on the persons involved in a dubious claim, may prove problematical from an IT compliance point of view.
For such searches, we have research workstations with access to the relevant databases, registers and information services, and special search profiles in social networks. As a first step, the loss adjuster can then be provided rapidly and inexpensively with basic information on the parties involved in a dubious claim.
Our services at a glance:
- Nationwide coordination, control and monitoring of all investigation orders
- Research in the relevant databases and registers (residents’ registration office, debtors’ register, credit agencies, etc.)
- Searches in social networks
- Systematic search and research strategy for resolution of specific issues
- Qualified research analysts
- Interviewing persons by telephone or in person
- Effective detection and identification of fraud indicators by qualified, experienced investigators with training in special interview techniques
- Compilation of a standardized, structured and quality controlled investigation report with a recommendation for action
All investigation results are collated in an investigation report which is subject to quality control and which lists all the means and sources used. Our research and investigation reports contain only objectively determined and verifiable facts. Subjective suspicions, interpretations and other conspicuous matters are provided as internal notes in a separate document.
