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Unfortunately a significant percentage of insurance claims are fraudulent. Operational
Risk Management Consulting can help you with difficult investigations, for example,
in another country, or simply verify facts which have already been (partially) supplied.
We would also be delighted to help train your investigators to investigate claims
effectively.
Insurance companies also need to be on the look-out for fraudulent (re-)insurance
certificates and when such appear we can help track who is holding such certificates
and where they came from.
Insurance Claims Case Study 1 : Insurance Claim Fraud
A West Coast insurance company often received claims for loss of livelihood and
business interference after accidents from Asia-based claimants who visited the
West Coast. Investigations revealed that in most cases the claims were unfounded
as the claimants circumstances were not as claimed, as corroborated by local in
country investigations in Japan, Korea, Taiwan and/or PRC and the insurance settlement
was adjusted accordingly.
