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Fraud

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January 16, 2020

How to find fraud in insurance claims

For insurers looking to stem the $30 billion-a-year insurance claims fraud problem, early detection is key. But with caseloads rising and hundreds of thousands of…

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December 20, 2019

Property/casualty medical fraud: 5 strategies for reducing your exposure

It seems like every month there’s news of another medical fraud bust, often involving rings of various types of providers. But that’s just the tip of the iceberg. There’s…

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November 6, 2019

Why data is critical to countering insurance fraud in Ireland

Insurers in Ireland need to look at how they can use data from a wide variety of sources to significantly reduce the risk of fraud at the application and claims stage.

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November 4, 2019

3 keys to stopping medical provider fraud, waste, and abuse

It’s no secret that medical fraud is a big problem, with some sources estimating the cost at more than $200 billion annually. But knowing the problem is one thing.…

Fraud
August 26, 2019

Getting serious about fighting medical provider fraud

Complex medical bills can make it difficult for adjusters—already overloaded with cases—to find potential fraudulent or excessive billing.

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July 18, 2019

Life insurance fraud: A holistic claims view key to detection

Life insurers can face a myriad of challenges today. Some of those issues have plagued the industry for years—such as stagnant premium growth and low interest rates—while…

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March 8, 2019

NYCM Insurance implements Verisk’s ClaimDirector and NetMap fraud detection solutions

NYCM Insurance has implemented Verisk’s newly enhanced ClaimDirectorSM and NetMap for ISO ClaimSearch® solutions to assist in accurate and early detection of potential…

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February 25, 2019

CMS to mask health insurance claim number and social security number on contractor correspondence starting April 2019

Starting 4/1/19, CMS’s Coordination of Benefits and Recovery Program program will mask the social security number (SSN) and SSN-portion of the health insurance claim…

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November 27, 2018

Uncover key claim details with social media

The average person spends two hours a day on social media. Hidden within the sea of tweets, snaps, and posts on these social platforms is valuable information for the…

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October 16, 2018

Uncovering fraud in auto extended warranty insurance

For most drivers, purchasing an extended automotive warranty for their vehicle means peace of mind in the event their vehicle malfunctions and needs critical repairs. For…

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July 30, 2018

5 questions to ask before building a claims fraud analytics system

With the industry focus and media attention on data analytics in insurance, many SIU leaders are considering enhancing their team’s investigative capabilities with a…

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July 16, 2018

Can insurance mitigate GDPR-related risk?

In the wake of the implementation of the European Union’s General Data Protection Regulation (GDPR), businesses worldwide are developing policies and processes to address…

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July 11, 2018

How a professional’s reputation can expose inflated claims

Trusting information at face value is a thing of the past. Claims professionals know this well, because they must gather information on a claimant and research prior…

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June 19, 2018

Blockchain security scrutinized

Blockchain technology has been getting a lot of attention recently, beyond just its role as the technology underlying “virtual currencies” like Bitcoin. Some have…

Data Governance
May 3, 2018

Ethics and data: Value in mature governance

Data can have many positive applications, but there can also be many risks with increased data dependency. Responsible data stewardship is critical.