Opinion: Reducing fraud surveillance costs and boosting closure rates

Opinion: Reducing fraud surveillance costs and boosting closure rates | Insurance Business

Opinion: Reducing fraud surveillance costs and boosting closure rates

Peter Moroney, director of investigations company Nemesis Consultancy Group explains why an online fraud investigation goes beyond a typical social media search.

 

Gone are the days of paying for excessive hours of surveillance that yield little results. Contemporary investigation methodology is cleverly moving investigations online, which can speed up case closure rates in an extremely cost effective way.

Undertaking in-depth online searches is far more advanced than a simple Google search, and can often uncover critical information that can be used to close cases before the more expensive traditional surveillance or factual (circumstance) is required.

Online investigation or desktop investigation should be used to complement other investigative methods such as surveillance or factual investigations. In the past, insurance claims officers would use competent surveillance and investigative personnel to establish legitimacy of and investigate claims.

However, as all claims officers will concur, the deployment of surveillance and investigations can be costly due to the length of time required to establish whether or not the claimant is legitimate in their purported claim. Identifying the most appropriate time to deploy surveillance can be largely ad-hoc, and the results can often be hit-and-miss.

The cost of online investigation can be half that of deploying actual surveillance, and when applied correctly, can aid in identifying and calculating the most opportunistic time for deploying surveillance (or an interview) that has the best chance of obtaining success whilst reducing costs. 

In simple terms, an online investigation is a thorough examination of the claimant to identify what information exists online with relevance to their purported injury. The majority of society today lives life to varying degrees online. We gather socially online, advertise and manage businesses online. Therefore, it is not surprising that most of us have some aspect of our lives captured and preserved online.

A competent online investigation goes beyond a simple Google, Facebook, White Pages and Twitter search, and will normally take anywhere from seven to 20 hours - sometimes longer depending on what is uncovered. It is a systematic untangling of everything electronic that can be identified and analysed about the claimant with particular respect to their purported injury. As little as $700 can be spent to save on claims worth several hundreds of thousands of dollars over the identified insurance period.

In addition to knowing how and where to source evidence that will aid in the case, a competent online investigator adds tremendous value by knowing how to capture, store and present that evidence so that it can be used effectively in relation to the claim – and this is often where the majority of cases fall down.

The days of wilfully allocating hour after hour on surveillance operatives should slowly start to fade as insurance companies benefit from the use of online investigations to aid in strategically investigating and closing claims. The end result should be reflected in reduced investigative costs due to the more appropriate deployment and use of investigation tools.

 

Example One:

A male claimant had a life insurance claim where he was receiving approximately $8,000 per month to the age of 65. At the time of the claim he was 47. So, for the remainder of the claim period there was a potential to pay out $1.2m. However, a several hundred dollar online desktop investigation identified that this male subject had been running a business while in receipt of the insurance money.

Despite the male subject’s best efforts to hide the registration of the business (it was in another person’s name), desktop enquiries were successful in connecting him to the ownership, management and day-to-day running of the online organisation. Surveillance would not have ever established he was actively involved in an online business. But an online desktop investigation, coupled with the strategic deployment of surveillance to cover advertised demonstrations, achieved the result that surveillance alone could not.

 

 

Peter Moroney is a former detective sergeant for the NSW Police Force and is a director of investigations company Nemesis Consultancy Group, which he co-founded with his father, former NSW Police Commissioner, Ken Moroney.