Crawford small claims pilot results in rejection of almost 50% of claims assessed

Loss adjuster Crawford has warned insurers that failing to screen low-value claims can exacerbate fraud.

Crawford conducted a three-month pilot in conjunction with an insurance company, in which smaller claims that would otherwise have been settled were tested for signs of fraud.

The trial resulted in nearly 50% of the claims assessed not being paid at all or the amount paid being reduced.

Twenty-one per cent of the claims were withdrawn by the claimant after being approached by Crawford. Nine per cent showed "so many high-risk fraud indicators" that they were referred to Crawford's fraud team for further investigation, and 17% of the claims were overstated by claimants.

Only 53% of claims were deemed capable of being settled unaltered.

Crawford head of counter fraud solutions Bobby Gracey said: "Some insurers put smaller, lower value claims directly into their supply chain to settle the claim without looking at whether there is fraud.

"But the study found that 47% of claims were handled differently. Doing this [assessing smaller claims] can save a lot of money for insurers."

Crawford undecided on use of lie detector
Crawford has not ruled out using lie detectors in the future.

The loss adjuster does not currently use the technology, preferring to use other methods including conversation management techniques. But head of counter fraud solutions, Bobby Gracey, said the company may have to look again at their use.

"Voice stress analysis is a great tool to have. But it doesn't strategically fit with our model at the moment. Insurers will often have used it at the notification stage, and our own risk assessment tools are working well."

But he added: "There may be a time when we have to be more sophisticated in our approach and we may reconsider its use."

Crawford is set to launch three major fraud product lines within the next month.

Bobby Gracey declined to comment on the details of the launch but said it would require 200 additional staff.

Topics