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jenniferwilson425

Jennifer Wilson's Blog

Coalition Against Insurance Fraud: Insurers from Mars, fraud bureaus Venus?

More common ground needed on reporting, acting on suspected scams

 

I just returned from the NAIC’s summer meeting. It included the antifraud task force meeting, attended mostly by directors of state insurance fraud bureaus. I also met with insurer SIU directors before the NAIC event.

 

I felt as if I’d entered a time warp. Discussions at both meetings reminded me of a breakout session I chaired at a Coalition summit more than a decade ago on the status of insurance fraud fighting. SIU directors and fraud bureau directors both attended.

 

The main discussion by insurers then was about the “black hole” of information sharing. Insurers said they send cases to fraud bureaus for investigation, and never hear a word back. The fraud bureaus contend insurers send them weak cases, or ones not well-vetted.

 

That’s what I heard last week as well. Insurers seemed at a loss about what happens to their cases they refer to fraud bureaus. And, several fraud bureaus grumbled about the lack of good referrals from insurers.

 

Insurers and fraud bureaus clearly need better dialogue so everyone fully understands each other’s needs.

 

One fraud bureau chief talked about how a few insurers in his state haven’t reported a suspected scam in years, even though reporting is mandatory. Are those insurers doing such a good job that nobody’s trying to scam them anymore? Doubt that.

 

Insurance-fraud laws broadly define the crime, though there’s no definition of suspected insurance fraud. Each insurer could have its own definition, which determines which and how many cases it sends to the fraud bureau.

 

Most insurers don’t report all suspected frauds. We understand that. Besides, fraud bureaus don’t have the staff to handle every case. But for an insurer to say it has no suspected frauds to report does a disservice to the larger fraud-fighting community and our common cause.

 

Fraud bureau directors and SIU leaders need to come together, develop a greater understanding and find more common ground so they can work jointly to combat fraud in the most efficient and effective ways possible.

 

We urge both sides to reach out to the other to make that happen.

Fraud Labs Pro Fraud Detection and Fraud Detection Solutions: What is ISP usage type validation?

From an IP address, you can find out where the IP address is coming from, whether it's from a fixed line, a mobile line, a military IP and so on. This is what we referred as ISP usage type in our fraud verification system. This information plays an important fraud indicator in telling you if any phishing activity behind the scene. For example, if you found out an IP address coming from Data Center/Web Hosting/Transit, chances are they may not be a legitimate buyers. You may want to flag this order for fraud review and manually calling them for further authentication.

 

What are the ISP usage types supported?

 

  • Commercial
  • Organization
  • Government
  • Military
  • University/College/School
  • Library
  • Content Delivery Network
  • Fixed Line
  • Mobile Line
  • Data center/Web Hosting/Transit
  • Search Engine Spider

 

Below are the steps on how to configure the usage type validation

 

1. Login to the FraudLabs Pro Merchant Control Panel.

2. Click on the Rules then click Add Rule.

add fraud validation rule

3. Select ISP Usage Type below the IP Validation

IP Validation

4. Select the Condition.

configure fraud rules - ISP type validation

5. Select the ISP that you wish to validate.

configure fraud rules - ISP type validation

6. Choose the action you want.

configure fraud rules - ISP type validation

7. Click Add Rule and don't forget to click Save and you are done.