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Zero tolerance one key to stopping fraud

Whistleblowers, technology and zero tolerance are the keys to combating fraud, according to Zurich General Insurance Fraud Manager Asia-Pacific Adam Plummer.

Speaking at a conference on fraud in Sydney today, he said insurance fraud is continuing to grow following the global financial crisis.

“Prosecution of fraud, civilly and criminally, is a challenge for all organisations, but we are seeing the development of a number of avenues to combat it.”

Mr Plummer says the 2004 amendment to the Corporations Act providing protection for certain whistleblower activities and protection of whistleblowers from prosecution has introduced “a major resource to combat fraud” within organisations and businesses.

“Whistleblowers can provide valuable information and intelligence on the corrupt internal practices of fellow staff members and management,” he said. “They also provide valuable information to insurers around the commission of fraud in insurance claims.”

He says an effective and efficient data analytics program can provide insurers with the ability to determine links and relationships between parties involved in insurance fraud scams.

Insurers should establish internal claims specialist fraud teams and flexible fraud indicator control programs to help detect suspicious claims.