Grange looked at a demo of an InfoGlide, Inc. "We looked at a couple of products that were focused on attacking fraud rings and suspicious trends," Russell says. The other piece of the puzzle was evaluating products for data mining, data visualization and link analysis. One part of the search was to see what technologies might help Grange red-flag potentially fraudulent claims up-front through NICB (National Insurance Crime Bureau, Palos Hills, IL) fraud indicators, Russell says. You can't fight fraud effectively without technology," he comments. "We needed to look at all the technology tools possible to aid in our efforts. "We decided we needed to reengineer the whole process," according to Russell. The referral rate of suspect claims to the SIU was somewhat low compared to industry standards, according to Russell, and it was evident that communication among departments could be improved. "We felt we had a good SIU special investigations unit and a good claims department, but we didn't feel the processes were working as effectively as they could." "We formed a project team a little over a year ago to take a look at all our processes for the identification of potentially fraudulent claims," says Mark Russell, vice president claims, Grange. ($956 million in assets under management) to think that it was not fighting fraud as effectively as possible, it looked for a way to reengineer its fraud-response capabilities. When industry fraud-reporting information such as this led Columbus, OH-based Grange Insurance Co. In fact, not only do the perpetrators know which companies are tough on fraud, but they may even narrow activities down to the level of which specific adjusters to hit within an insurance company. Just as fraud investigation gets more sophisticated, so do the organizations and individuals perpetrating fraud. Fighting fraud is like shooting at a moving target.
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