Making the Right Decisions in Fraud Investigations

?Best practices? is a clich? that means a lot of different things to various professionals. Analytics can mean different things to business and government executive leaders. When you leverage best practices and analytics together in insurance fraud investigations, however, a powerful tool and business model is created that will create significant results to reduce fraud and provide a great Return On Investment (ROI) in anti-fraud programs.

Four key components to enhance the ROI for insurance fraud programs are:

  • Risk Management
  • Training
  • Policies and Procedures
  • Performance Evaluations

People are communicating more and more through social media platforms like Facebook,Twitter, Foursquare, Google Plus and Pinterest. The number of social media websites is growing everyday in our flat, global economy. Risk is always the number one concern of the executive leader when it comes to operations and personnel. How do you know you are meeting your goals and objectives? Are you agile enough to change direction during a critical incident; in other words, can you predict (and prevent) an incident that will drain your resources?

Analytics is not a single software solution,nor is it a single management or decision-making tool. Analytics is all about leveraging data with best practices that result in more informed decisions. Unfortunately, this power is all too often left unused or underutilized in our industry.