One in ten Groupama motor claims are dropped following a ‘cognitive interview’

When the economic going gets tough, the fraudsters get going. At least that’s the conclusion you might draw from the statistics for false motor insurance claims.

Some of this crime is opportunistic, some of it is organised – all of it is bad. It is bad for insurance companies, because it skews underwriting calculations and ruins the performance of motor books; bad for brokers, because it perpetuates the notion that the insurance sector is fair game; and bad for honest policyholders because it bumps up the cost of any insurance policy by about £40.

Groupama saw the value of false claims rise by 10% in 2009 – and it is important to recognise the effect on us all.

Responsible insurers have a duty to their stakeholders and, crucially, to honest policyholders, to fight fraud at every opportunity. This calls for a delicate balancing act: we need to put obstacles in the path of fraudsters without making it difficult for genuine claimants.

So insurers are always looking for subtle but effective ways to detect and deter would-be fraudsters. Cognitive interviewing and conversation management are valuable techniques. They make it possible to manage genuine customers effectively, while still alerting claims handlers to suspicious cases.

So what is cognitive interviewing? It is nothing sinister. It simply allows trained professionals to help genuine customers recall the circumstances of their claim in detail. At the same time, the interviewer can listen for tell-tale signs that someone is not lying. Once the interviewer suspects a falsehood, the conversation can be managed to expose more fabrications.

Genuine claimants will normally see such an interview as a helpful part of the claims process, but anybody intent on deceit will soon feel the pressure. Groupama’s success supports this. More than one in ten of the private motor theft claims we received from March to December last year were withdrawn without explanation; a further 16% of cases were concluded when the vehicle was recovered. A few were genuine claims involving the police, but there was a good number of cases where the miraculous recovery of a vehicle followed direct questioning.

In one case where suspicions were aroused, a claim for an expensive car was withdrawn as the vehicle had been “hidden round the corner by friends”, who finally owned up to the joke. Strange, as the claimant had kept all the car keys.

Groupama is comfortable with telling customers about our counter-fraud activities. We are also straight with potential fraudsters. By deterring dishonest claims early, we save time and money.

However, we don’t simply wave potential fraudsters goodbye. Many regard insurers as fair game and will try their luck elsewhere. Beating fraud cannot be a competitive issue. It is imperative that insurers talk

to each other, supporting the Insurance Fraud Bureau and the Insurance Fraud Investigators Group, and sharing information via systems such as Hunter.

We will not win until we persuade people that defrauding an insurance company with a false or inflated claim is no different to any other crime. IT

Stephen Teeling is counter fraud manager at Groupama Insurances.