The study states that the optimal model for the prevention of fraud should include specific strategic, organizational, process, technology and data components
The study states that the optimal model for the prevention of fraud should include specific strategic, organizational, process, technology and data components. Strategy: In order to successfully reduce the financial and operational impact of fraud, senior management must set the proper “tone from the top”, which means the problem of fraud communicate as a serious business problem that must be worn and management, not just the leaders responsible for the damage. Such an approach will clear organizational boundaries and to establish cooperation between the key functions that can successfully detect problems.
Organizational: The need for qualified resources, training employees on the front lines and well-defined roles, duties and responsibilities. Care should be taken and that the employees of external service providers (outsourcing), and who are in contact with the areas subject to the risk of fraud, involved in programs to prevent fraud and accordingly educate. Many insurers have special features for conducting investigations, however, they are not optimally integrated with other functions, and they need continuous training and new tools to achieve key objectives.
Process: Product development and sales process can be a tool in preventing the issuance of insurance policies potentially unfair clients. This can be achieved through systematic monitoring of trends and indicators of fraud, which will then be implemented in a comprehensive set of information for improving the prevention and deterrence of fraud.
Technology and data: Better quality data and predictive analytics can help insurers to fight fraud. Analytics is actually the basis of optimal programs for the prevention of fraud. Many insurers already use advanced analytical tools to combat fraud. However, for insurers is crucial to know to identify the current status of data, analytics and maturity of the operating system, in order to adequately direct the efforts and investments in the fight against fraud.
How fraud in the industry are becoming more sophisticated, insurers need to step up efforts to protect the quality clients, discovered the organized fraud and improving the efficiency of analytical tools and specialized units to conduct investigations within the company. The strongest weapon in this way is certainly strategic thinking about the overall program for the prevention of fraud, not only focus on what “it” is done, but also the “why” and “how”. Insurers must be aware that in order to increase the importance of cybercrime on the list of strategic priorities, so must the prevention and detection of fraud.
We must not forget that in the fight against fraud is also crucial and cooperation of all insurers and government institutions at the local, but also international level, as well as raising awareness of the unacceptability of such behavior.