FRAUD


‘Our tool helps to reduce the cost of damages’

Fraud is a growing phenomenon in the insurance industry in every European country. Foreign claims appear to be even more vulnerable to fraud, due to language barriers and the excuse of ‘foreign legislation’, making it easier for fraudsters with a big social impact as a consequence. After all, a successful fraudulent claim results in higher claim costs for the insurers and, consequently, higher premiums for the honest consumer. Therefore, CED supports the initiatives of insurers for the prompt detection and prevention of fraud along with taking action against the perpetrators. Our dedicated fraud management tool helps us do this.

In common with the rest of the CED Group, CED CBC has an integrated fraud detection system within our claim handling process. On the basis of predefined criteria, we can trace suspect claims, quickly and expertly. Once a possible fraudulent claim is detected, the case is referred to the Fraud Coordinator who prepares a report for the client, including a recommendation for further investigations if necessary. If the customer agrees to pursue fraud investigations, the matter is followed up by the Fraud Coordinator. CED Fraud Management employs specialists throughout Europe who are full time dedicated to fighting fraudulent claims. They also have access to an international network of insurance fraud investigators.

Adding value to clients and society

One of our Fraud Coordinators is Thomas Laperna from CED Italy. He is not only a passionate antifraud investigator, he also truly believes this is the way CED CBC can add value to society. He says: ‘We started in Italy with fraud management in 2018. As an experienced claim handler, I wanted very much to lead our fraud department, because I knew I could in this way offer our clients even more value. We now work with a special team of technical experts, doctors and lawyers, located in all the Italian regions, giving us the possibility to work professionally throughout all Italy. My goal was to gain an important reduction of fraudulent claims coming from third parties, thus saving much money for the insurance companies we represent. Next to that I am proud to say that our activities have helped the Public Prosecutor’s office to unmask important frauds.’

Witness in 36 different accidents

An example of a recent fraud ‘unmasked’ with the fraud management tool of CED happened in Eboli, a small village in the south of Italy near Salerno. A car left a parking lot, hit another vehicle and crashed into the crash barrier – that was the story. But immediately after the first check with the fraud management tool on the claims from the owner and the driver of third party’s vehicle, CED knew they must be fraudulent. One of the indicators was the name of the witness, which had appeared in the CED systems before. CED rejected the claim and appointed an investigator. After the rejection, as nearly always happens, the third party issued legal action. Happily, the outcome was that we were able to uncover the fraud because we highlighted all the anomalies to the judge – in particular the fact that the witness introduced by the third party had been a witness in 36 different accidents…! As expected, the judge rejected the claim, condemned the third party to reimburse us and, above all, reported in the judgement that the witness was not reliable. Thanks to our fraud management tool and our further investigations we were able to reduce the damage costs for our insurance company client.

CED’s process of fraud management

On the basis of predefined criteria, we trace suspect claims

Once a possible fraudulent claim is detected, the case is referred to the Fraud Coordinator

Fraud Coordinator prepares report for client, including recommendation for further investigation

If our customer agrees to pursue fraud investigation, Fraud Coordinator opens a separate investigation file

CED keeps client informed of next steps, and advises on legal frameworks (e.g. around privacy)

Are you interested in our fraud management?

Please, contact us!