FIGHTING INSURANCE FRAUD USING TECHNOLOGY

Abstract

The risk of insurance fraud, or fraud in general, has been analyzed for a very long time, but at the current moment it has become more intense. Insurance fraud has many aspects related to traditional claims (for example: death, disability, income protection and hospital claims). However, there are other areas of concern that increase the potential for parties to commit fraud. The impact of COVID-19 on global business is undeniable. Unfortunately, however, as accounts receivable grow, so does the risk of fraud. Using technology-based solutions identifies red flags of fraud and minimizes disruption to the claims process to ensure customer response times are top notch and legitimate claims are not unnecessarily delayed. COVID-19 has been a factor for remote work in most fields and companies, while increasing the use of technology. Determining risks and responding to them must take place through consistent and effective processes. This can be enhanced by the correct use of technology. Combining technology with effective resources and experienced staff is a priority step to maximize robustness in deterring, preventing, detecting and responding to suspected fraud incidents. If financial losses associated with fraud are one of the consequences, then investing in technology and skilled and experienced resources is an imperative. Brand damage and loss of investor confidence pose some critical and additional considerations when assessing fraud risk and a firm's response to fraud.

Keywords

• : insurance fraud; fraud detection; risk; strategy