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Combating Insurance Claims Fraud

March 25, 2018

Insurance companies should consider the possibility that 10 percent to 20 percent of all claims may be fraudulent. The impact is enormous. Fraud losses weaken an insurer’s financial position and undermine its ability to offer competitive rates and to underwrite reputable and potentially profitable business. For policyholders, fraud losses lead to higher premiums. In this supposedly victimless crime, everybody ends up paying the price. Governments have responded with new regulations and centralized fraud bureaus. Insurance companies have responded by establishing special investigative units (SIUs) armed with computer-based tools to detect and prevent fraud. Yet the problem continues to grow, and in recent years, it has grown significantly.

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Combating Insurance Claims Fraud