Insurers benefit from fraud risk profiling

Hill Dickinson Fraud Unit (HDFU) has reported a 122% increase in suspected frauds identified through its Netfoil database over the first quarter of 2013 following the introduction of its fraud risk profiling model.

The new model, launched at the beginning of the year, identifies parameters of fraudulent claims from a database of 10 years worth of claims data. Suspect claims that contain these identified characteristics are then flagged by the model and reviewed by a HDFU analyst before being reported to the insurer for further investigation.

HDFU director of intelligence and complex fraud Chris Hallett said: “Where we profiled a fraud claim or fraudster we were able to say that a fraudulent claim would fit these parameters. Although we may not know the individual because he was made up yesterday, because he has provided this sort of surrounding information, there is a fairly good chance that the claim needs to be looked at.”

The law firm’s Netfoil mass data analysis (MDA) service can also be customised to individual insurers needs by adjusting the risk score at which claims are treated as suspect. This allows the volume of reported claims to be tailored to the clients individual risk appetite.

Hill Dickinson head of fraud Peter Oakes said: “This powerful fraud screening tool supports efficient, proactive claims handling, in turn leading to reduced claims life cycles. Fighting fraud can be an expensive business for insurers, but the ability to flex the Netfoil MDA scoring matrix to receive targeted results, aligned to their counter fraud strategy and available resource is invaluable.”