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Combatting Fraud: Tips from Insurance Canada

Combatting Insurance Fraud

Toronto, Ontario — History has demonstrated a concerning pattern: in times of economic crisis, there is a huge surge in insurance fraud across most businessesincluding the automotive industry. 

During this unprecedented time Tom Hawkins, West Bend Mutual Insurance’s Director of Claims predicts that fraud will increase dramatically, which is why they released a report to arm businesses with the best practices and examples to keep a lookout for. 

Expect opportunistic fraud

When human interaction is low, staged incidents and accidents become more common. The industry should look out for:

  • An increase in staged accidents and vehicle thefts
  • Procedure billing for phantom services (including telehealth)
  • Fake accidents occurring at homes

Thwarting fraud 

Embracing technology could be your best bet right now. With the right AI and machine learning in place⁠—alongside strategically built business rules based upon a global understanding of these types of situations⁠—business owners can continue to run their business without worrying about the risk of similar organized fraud occurring elsewhere in the business.

Using analytics can help identify the perpetrators through advanced methods, some of which include:

  • Entity resolution, including detecting altered identities
  • Network analytics
  • External data sources
  • Simply looking at prior claims history
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