Insurance Frauds Risk Assessment And Investigations

Normal 0 false false false EN-US X-NONE X-NONE Insurance Fraud Risk Assessment and Investigations: Knowing that application or claim is fraudulent is one thing, but proving this to be fraudulent is a different matter. Fraudulent applications, claims and surrenders account for a significant portion among all received by insurers, which adds up to company's overall costs.   There are various types of insurance frauds, which occur in all the areas of insurance, e.g., Fake application, fake documentations, false claims and surrenders, mis-selling, collusion between parties, etc.   Today, when India's insurance industry is working toward reducing costs, one of its main focus areas to control or reduce costs is by proactively arresting fraud, which can be achieved through an effective fraud risk assessment (FRA) program.   RTJC's FRA program includes:  - Efficient, smart, state of the art digital technology based policy holder and vendor due diligence process- Efficient claims validation process- Mystery shopping i.e., gathering market intelligence relating to tied and corporate agents, brokers, etc.- Channel reviews pertaining to tied agency, bancassurance and tele calling - Contract compliance reviews including review of advertising expenses, intellectual property (IP) compliance- Fraud analytics and electronic dashboards /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;}