INSURANCE FRAUD

Insurance Fraud

Insurance Fraud

Introduction

It has been a significant problem for insurance companies to deal with automobile fraud rings. These rings, involved in vehicle fraud, comprise of medical practitioners, attorneys, witnesses, and insured parties. Furthermore, such groups have been a significant source of fraudulent insurance claims. As an intelligence analyst, it is essential to make use of the available information and gather new sources. This helps in forming a logical pattern across the members of the fraud group, and apprehending the perpetrators.

There are a number of ways to detect and investigate fraud. Most of these ways are common among the insurance companies, law enforcement agencies, and intelligence analysts. The propriety statistical methods of CityPlus Insurance can be beneficial in identifying the suspicious claims. In addition, as an intelligence analyst, going through the suspicious claims can provide additional clues (Phua Lee Smith & Gayler, 2005). There may be instances in which, private citizens step forward and report suspected fraud cases to the police, or those organizations which investigate such frauds. These may include the National Insurance Crime Bureau and the Coalition Against Insurance Fraud.

Benefit from an Intelligence Analyst's Experience

The work of the intelligence analysts will significantly help the investigation process and the investigation team. The work of the intelligence analyst entails methods which can analyze raw data and prioritize work accordingly to collect data from additional sources. There are a number of processes and strategies which an intelligence analyst may use. One of the most prominent methods is the use of data mining (Cortes & Pregibon, 2001). After the collection, process, and analysis of the data, an intelligence analyst can form logical patterns to identify significant leads. In addition, the analyst can develop such patterns pertaining to the suspected people by the use of algorithms. The formation of an intelligence product takes place after the completion of the intelligence process. The analysis and development of the case then disseminates to the rest of the team so that the appropriate team members can make use of the information to solve the fraud case. That is how, an intelligence analyst can provide valuable benefits to the investigation team.

Incorporation of the Intelligence Process

At first, it is essential to use advanced computer programs because they help in detecting frauds along with other computing methods. In addition, identification of suspicious relationships pertaining to the insured is also possible by using data. As an intelligence analyst, reviewing financial statements for suspicious cash flows may also be beneficial. That is how, identification of connections with common insurance crime rings become possible.

As part of the investigation plan, it is essential to use data mining techniques through computer programs. Data mining analysis entails the analysis of information and identifying logical patterns from large raw data in large databases. Although, data mining technique is beneficial for avoiding potential fraud attempts, this method is also useful in fraud investigations (Burge & Shawe-Taylor, 2001). Investigators can develop models based on past data related to fraudulent ...