Sedgwick’s fraud strategy saves clients $1.48 million

Over the past three years, the company has noted an increasing appetite for fraud mitigation in other countries such as France, Ireland and the Netherlands, with an emphasis on strengthening capabilities with cross-border activities across all product lines. Based on last year’s data, Sedgwick predicts that fraud and suspicious claims activity will continue to rise.

“Countries are at different stages of their claims fraud journeys; some are in their infancy, while others are more advanced,” said Steve Crystal, international head of claims fraud at Sedgwick. “Notwithstanding the challenges of differing legislation, regulation, compliance, culture and market approach, there’s one common denominator: no matter the location or language, claims fraud is unwelcome news.”

Sedwick continues to enhance its fraud strategies in additional markets. For example:

In the Asia market, Sedgwick is working with insurer clients in Hong Kong and elsewhere to help them strengthen their approach
In South Africa, there has long been recognition of the issue, resulting in an advanced approach to fraud detection and containment. The Insurance Crime Bureau estimates that up to 30% of claims contain some element of concern

Sedgwick’s investigation team has detected cases of organized fraud in products not commonly seen in the US or UK, such as insurance-backed credit card protection schemes and the targeting of products sold globally with losses in remote locations. Sedgwick also noted a growing international focus on data residency and privacy regulation.

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Because fraud is not contained by national borders, the company encouraged markets to explore collaborative opportunities for sharing their data and findings while maintaining appropriate levels of protection and compliance.

“The majority of claims are completely valid, but we must not underestimate the resolve and determination of fraudsters who are looking to beat the system,” Crystal said. “Our experts are highly trained in quickly identifying and handling suspicious claims. To bolster their efforts, Sedgwick continues to invest in technology and advanced programs to assist them. Our approach is geared to tackling those who seek to find ways to bypass detection measures, with our experts interpreting what the analytics are telling us.”

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