Fraud in the U.S.A. — and beyond

Globe idea

When it comes to insurance fraud, the United States is a world leader. We arguably have the most severe problem on the planet. But we also have the most sophisticated means of combatting fraud. Our systems for detecting and investigating fraud are mature and much more robust than those in other developed nations.

But that doesn’t mean we can’t learn from other fraud-fighters around the globe. Last week I had the opportunity to travel to Bogota, Colombia and learn how this South American country tackles fraud. I was pleasantly surprised to see the progress fraud-fighters had made in just a few short years.

The country has its own version of the National Insurance Crime Bureau to work with insurers to detect and investigate fraud across most property/casualty lines of insurance. They use sophisticated technology to identify patterns of criminal activity, and they have conducted consumer-tolerance studies that rival anything in the U.S.

During a fraud summit at one of the country’s premier law schools, representatives of other countries also reported progress in detecting and investigating fraud. The delegate from Argentina, a country more associated with fine beef and spectacular glaciers than with insurance fraud, detailed a campaign to unite insurers and law enforcement against that country’s organized rings.

Britain’s top fraud-fighter also attended the summit and recounted impressive gains in the U.K. in the just two years since insurers formed the nation’s first fraud bureau. The technology employed in the U.K. easily equals, if not surpasses, that employed in the U.S. Additionally, insurers in the U.K. have established benchmarks across the industry that enable insurers to measure their anti-fraud results — something sadly lacking in the U.S.

I left South America with a host of good ideas that I plan to pass on to the fraud-fighting community in the U.S. I thought about my experience Monday, while attending the opening session of the IASIU annual seminar. President Dave Rioux asked everyone in the audience to look at the persons to the right and to the left. Each of them has ideas that can help you become a better fraud-fighter, he said. He implored conference delegates to engage one another, learn from one another and enhance the overall professionalism of insurance investigators.

Insurance fraud is a complex, multi-faceted problem. No one person or organization or country has cornered all the good solutions. If we embrace the concept that we can learn from anyone, we will all be better fraud-fighters for it.

P.S. As we head into the weekend, please keep the people of the Houston area in your thoughts as Hurricane Ike approaches. We hope the many claims people and insurance investigators who are making their way to Texas to aid storm victims remain safe as well. Consider a donation to the Red Cross to aid the many whose homes and businesses likely will be lost.

Fraud-fighting community loses a leader

Bear BryantToday marks the first day of a new era for the National Insurance Crime Bureau. It’s the first day in many years that the steady hand of Bob “Bear” Bryant isn’t steering the organization. After nine years at the helm, and with almost no fanfare, Bear retired yesterday. No big retirement bash. No long-announced departure date. He eased into retirement quietly. That says a lot about a guy who was a key leader in the fraud-fighting community.

There was no over-sized ego to get in the way of getting things done. Just competence and a ton of integrity focused on the difficult job of detecting and investigating fraud while dealing with the demands of a thousand or so property-casualty insurance company members.

Bear came to lead NICB after a long and storied career with the FBI during which he rose to the highest levels of the federal agency. He brought his organizational experience to NICB and enhanced systems and the level of professionalism throughout the organization. He restructured NICB, making it less an extension of company SIUs fighting one fraud at a time and more of an analytical entity to uncover broader patterns of criminal activity. He was an early adopter of technology to prevent and recover stolen vehicles that led to the downward trend of car thefts across the country.

He created NICB’s successful medical task forces that now operate in key cities around the country, focusing on medical provider fraud. Working with insurers and law enforcement, the task forces have put a long string of crooked doctors and clinics out of business.

During the last year, Bear implemented a new strategic business plan that’s likely to take NICB and fraud fighting to the next level. He often said his goal was to leave the organization in better shape than he found it. He certainly did that and much more. The fraud-fighting community is a better place because of Bear’s leadership. We wish him a long and fun retirement.