Counter Fraud Services


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The "One World" of global fraud investigation services

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Counter Fraud Services

  1. 1. Counter Fraud Solutions Crawford & Company is the world's largest independent provider of claims management solutions to the broker, corporate, insurer, reinsurer as well as self-insured entities, with a global network of more than 700 locations in 63 countries. Counter Fraud Solutions is an innovative, global service which draws upon Crawford’s extensive insurance experience and expertise to help our clients define and implement a comprehensive fraud strategy. This protects against financial crime and, most importantly, delivers financial savings that directly influence client value through increased profitability. Counter Fraud Solutions (CFS) was created to address the industry’s concerns about the growing incidence and cost of insurance related fraud, and to provide a cost effective fraud management solution, in line with our clients’ own fraud strategy. We also work closely with our clients to help them to demonstrate to any industry regulator, via meaningful and robust management information, that they have the ability to manage fraudulent claims whilst treating genuine claimants fairly. As a result, CFS delivers exactly the counter fraud solution clients require, from fully branded service specific packages to a complete claims management outsourced facility, providing first class customer service. By combining our claims handling expertise with innovative technology and proven psychological techniques, our fraud solution guarantees fast and effective claims resolution. Genuine claimant’s progress to early settlement, whilst potentially fraudulent claims receive the further attention they require. Using this approach we consistently deliver a client value with a market leading return on investment. We believe it is critical to deliver tailored fraud management solutions based upon client specific needs and that these are always aligned to documented fraud strategies and objectives. Our approach is comprised of three key elements: Detection - Identification of high risk and suspicious claims Investigation - Management and investigation of high risk and suspicious claims Articulation - Production of relevant management information With the increasing spotlight on the cost of fraudulent activities to the insurance industry, and regulator concern about Treating Customers Fairly, there is increasing focus being placed on insurers in terms of their responsibilities to their genuine customers, and also their shareholders, in relation to the prevention of financial crime. Our Counter Fraud Solutions service enables us to draw upon our industry experience as investigation market leaders, to help our clients, regardless of their size or geographic location, to define and implement their own strategies for fraud management. Our years of collective insurance industry experience and strength in depth, enable us to quickly respond to all eventualities. We are also proud to be recognised as a market leader with a strong commitment to industry education. In recent months, for example, we have published a White Paper on Claims and the Credit Crunch and co-authored a Claims Handlers Guide to fraud. Both these publications are available to download for free at Contact Us Bobby Gracey Vice President Global Counter Fraud Solutions Trinity Court 42 Trinity Square, London, EC3N 4TH T: +44 (0)20 7265 4386 M: +44 (0)7919 552611 E:
  2. 2. Counter Fraud Solutions Our Services Counter Fraud Solutions - SCORE SCORE (Scientific Customer Orientated Risk Evaluation) is our cognitive interviewing fraud management process. Using a combination of applied psychology, conversation management techniques, behavioural analysis and practical devices, we are able to accurately assess the fraud risk and validity of a claim, without making genuine claimants feel defensive. This service is most effective in the high volume sector of the industry and, in a customer focused way, directly identifies the opportunistic fraudster. Utilising our SCORE process, several of our clients have enjoyed a reduction in claims expenditure of over 60% with repudiations and claim withdrawal levels in excess of 30% in personal lines, particularly in travel and motor claims. Counter Fraud Solutions - Field Investigation Whether our clients require surveillance of an injury claim, investigation of cause and origin or a comprehensive response to motor theft or fraud, CFS can provide a cost effective investigation service. Our team of highly trained investigators inclusive of: former senior police officers, adjusters and surveillance specialists are experienced in validating claims and identifying potential fraud as early as possible. We have developed an evidence-gathering process that is consistent and thorough ensuring effective risk evaluation, accurate validation and enables genuine claims to be quickly identified. In complex investigations, where evidence-gathering is a particularly vital part of the process, we have access to the latest technology, forensic teams and document analysis tools. We also work with information providers and other software systems in our investigation process, as required. We build diverse teams depending upon the nature of the enquiry. Utilising the wide resources of the Crawford group, we can tackle personal lines, commercial, high net worth, bespoke theft enquiries, marine, cause and origin, travel, health and computer fraud. Our field investigation services comprise: • Domestic and commercial • Major and complex losses • Surveillance • Guardsman Motor • Guardsman Creditor • Liability Our client focused services deliver a market-leading return on investment, through effective detection of potential fraud and consequent repudiation, withdrawal or non payment of fraudulent claims. Counter Fraud Solutions - Consulting Recent consulting projects for CFS include a full review, on behalf of a global client, of their claims fraud processes within Europe, Asia Pacific and Latin America. There was a key requirement for this review to be performed within a short timeframe. This was completed and delivered in under 5 months. As a result of our recommendations, the client is now rolling out these changes in a phased approach in territories outside of the USA. Most importantly, it ensures that genuine customers are supported by identifying fraudulent claims activities, helping to provide financial benefit for customers as well as the client during these difficult economic times. The nature of risk is constantly changing and, as claims become increasingly more complex, the need for expert skills grows. Today, losses often require a range of specialists, including accountants who combine strong commercial knowledge with a deep forensic insight. Crawford Financial and Forensic Accounting Solutions in the UK comprises a growing team of professionally qualified and highly experienced staff, working within Crawford’s Counter Fraud Solutions team, which resolves complex financial issues including: business interruption, advanced loss of profits, contingent business interruption, stock and fidelity guarantee claims, fraud and personal injury. From first notification of a loss, CFS work seamlessly with our team of property and liability adjusters to provide immediate assistance in developing claims settlement strategies. We also offer financial ‘health checks’ on certain claims via our financial validation services.