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We have been considering migrating our claims notification process away from the phone and onto the web. We feel that this offers the most effective customer service proposition in a rapidly modernising technological age. Do you see any downsides?
In the US, the Insurance Research Council (IRC) and Insurance Services Office, Inc. (ISO) Fraud Survey of 2000 reveals that a significant proportion of surveyed companies estimate that 21 percent or more of total claims contain elements of fraud. In the UK , via DigiLog’s AVS, it can be shown that the reality approaches 30% – of which almost two thirds are being successfully defeated. Although web based claims notification may indeed enhance the ease with which a customer may register a claim, you will more than likely have to accept that this customer service’ proposition will extend to both genuine and dishonest customers; hence you may very well deliver enhanced customer service “ but why would you want to be doing that to the fifth or more of your customers who are less than genuine? You will rest uneasily in the knowledge that fraudsters revel in remote, non-human interfaces. The internet tends to demand quick and slick’ questioning routines too “ yet more music to a fraudster’s ear. Ask them a one dimensional question and they’ll give you a one dimensional answer “ how can you test the integrity of one or two word answers or ticks in boxes? Additionally, from a psychological perspective, it is far easier to lie to a machine’ than in direct communication with a fellow, interacting, human being. By failing to deploy robust anti-fraud routines at the front end, you may well become increasingly attractive to those that are displaced by those that do.
How can we justify decisions to decline claims or applications simply on the back of a technology?
You don’t. The technology is only one part of a dual approach that, at first point of notification, combines with cutting-edge behavioural analysis techniques that can accurately pinpoint truthful claims. This dual approach ensures that the subjectivity of an operator’s opinion in critical decision making is both underpinned and robust.
When reporting an insurance claim shouldn’t we assume that everyone can be stressed?
At the start of every conversation, the Voice Risk Analysis technology calibrates itself against the caller’s voice, to determine the current levels of various stress a person is experiencing. The technology will then use this individual baseline as a guide to determine whether a person’s stress levels fluctuate when talking about a particular subject. Only meaningful deviations from this baseline are used to determine the integrity of the conversation “ via in-depth analysis of patterns found within the voice.
Do we have to tape record our phone conversations with our customers?
No “ the techniques are all highly effective in real time “ however, there are advantages to tape recording “ in particular for evidencing the movement of goal posts’ as the potentially fraudulent customer attempts to weave a way around the immensely powerful obstacles placed on the playing field by intelligently focused probing. A customer’s credibility can be totally undermined by such ambiguous evidence. That said, the need to go this far is rare indeed.
Should we inform our customers exactly how we are analysing their claim or application?
For much of the past, customers have been largely unaware of what formed part of any process instigated to validate their claim or application. Additionally, we have only previously been able to take at best an educated guess as to whether a claim was suspicious or not, resulting in the possibility of both the genuine and the fraudsters being subjected to scrutiny. Indeed some of the more traditional methods, including profiling, financial status checking and surveillance, could be considered to be in the grey zone when it comes to whether or not it is ethical to use them at all. Recent regulation and guidance in a variety of areas has assisted in removing some of that greyness. DigiLog recommends as a minimum that companies inform customers who phone in to their call centres that all telephone calls relating to applications and claims may be tape recorded and analysed for the purposes of fraud prevention and detection. We recommend that companies are quite open about using the VRA technique as part of an overall process designed to sift the truthful from the disingenuous. After all, the concept is not new. Human beings have been using their own computer “ i.e. their brain, to assess truth or deception in conversations since we first learned to communicate. Publicising the use of VRA and associated AVS techniques, does two jobs “ reinforcing the stance against premium inflating fraudsters for the benefit of the honest, whilst acting as a deterrent to those that are thinking of cheating.
What product lines are suited to this type of screening?
DigiLog’s AVS is suitable for any scenario where you need to validate customer integrity within conversation-based transactions, either over the phone, or indeed face-to-face. The solution is designed to handle even large volumes of calls efficiently and effectively whilst being as customer friendly as possible.
How about media or customer reaction to the deployment of this type of solution?
Undoubtedly early deployments of such a innovative and immensely effective process such as AVS can prove newsworthy. The key to successful media management is proactive, clear and informed communication and capitalisation of good news aspects. In reality, this process is good news for everyone except cheats and thieves. Successful media management will be optimised by concentrating on the very real goals underpinning all good fraud prevention strategies “ to eliminate the costly risks of fraud that are ultimately paid for by honest customers and corporate stakeholders. DigiLog’s Advanced Validation Solutions enhance customer service provision whilst ensuring that decisions to decline applications or claims are both correct and justified. For insurers, experience to date shows the process to be very definitely win win’ all around for genuine customers who will undoubtedly be more inclined to continue being a policy holder when renewal time comes around.
How do we go about implementing AVS?
Via cost effective deployment of pilot processes in those product lines that risk assessment and experience tells us are prone to claimant fraud. We recommend that a pilot run for between 4 and 6 months. Please talk to us. Together – we can work it out.
Can we use AVS reports as evidence in a court of law?
In the UK , the Financial Services Ombudsman underlines our approach via statements in the British press, publicly accepting the validity of VRA results as evidence within a case provided it is supported by other, corroborating evidence. However, cases presented at court require real, tangible evidence in order to ultimately prove a case. DigiLog’s main contribution in this area is to help identify precisely what evidence may be available and point to how it may be found.