General Casualty fights fraud with education
By Kathy Suhey
Special Investigative Unit Manager
In a time when more and more policyholders think it's OK to pad insurance claims and professional fraud rings are getting more organized and complex, insurance companies like General Casualty are doing our part to stop them. Our special investigative unit (SIU) is dedicated to combating this costly crime, and one of our primary tactics is education.
We've armed employees, agents and policyholders with information to help them identify and prevent fraud. To help us in that mission, we've partnered with national organizations that provide several resources.
Plugging in employees
Our entire claims staff uses databases to help analyze fraud indicators and claim histories. Each year partner companies enter tens of millions of claims into these databases, and that information helps identify claim patterns and detect suspect claims. We use ISO ClaimSearchâ and the National Insurance Crime Bureau's (NICB) Questionable Claims database.
In addition, our SIU staff visits each regional office every year to provide ongoing fraud prevention training for claims employees.
Agents defending the front line
Agents are our first defense in preventing insurance fraud against General Casualty. When taking applications, we ask that agents take a common-sense approach and ask additional questions about anything that seems unusual. We've also published a "Focus on Fraud" brochure for our agents that lists common fraud indicators, as determined by NICB research.
When agents encounter a suspicious applicant, they should alert their underwriters. We then refer the suspicious application to their state's fraud bureau and the NICB for further review.
Spreading the word to policyholders
It's important policyholders understand that their rates are higher because of insurance fraud, especially as it becomes more socially acceptable. NICB calculates that insurance fraud costs Americans about $30 billion each year. That's $200-$300 in higher insurance premiums for the average household.
At General Casualty, we're planning a campaign to include educational brochures in customer mailings. They explain how rates are affected by insurance fraud, teach customers how to avoid becoming a victim, and provide NICB's hotline to report suspected insurance fraud: (800) TEL-NICB (835-6422). We've posted additional fraud information on the consumer section of generalcasualty.com.
ISO ClaimSearch is a registered trademark of ISO Properties, Inc.
About the author: Kathy Suhey, General Casualty's Special Investigative Unit Manager, has more than 20 years of claims and SIU experience. She's been with General Casualty since September 1991.
For more information please contact Anne M. Smith.