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Post by Dr. Michael Skiba
Dr. Skiba (also known as “Dr. Fraud”) has worked in the insurance fraud industry for 22 years in various claims, Special Investigations, and leadership roles. He is currently Vice President of Counter Fraud Strategies at INFORM. He has also been a professor for 12 years and is currently Lead Faculty of Fraud Management at Colorado State University Global Campus. He is an international speaker and regular publisher on the topic of insurance fraud. He holds an MBA and a PhD with a concentration on economic crime and insurance fraud. He is also the President of the NY Chapter of the International Association of Special Investigative Units.
Insurance claims consume nearly 80% of insurance company‘s premiums in the form of payments, fraudulent losses, and processing costs. Therefore, insurance companies are justifiably concerned about optimizing the claims process but are often unsure about the most effective method to accomplish this.
Why Do Fraudsters Commit Fraud Over Other Types of Crime? This second part of the article (see PART 1 - Feb 2016) we talk about the Fraud Triangle, developed by Columbia University. The Fraud Triangle is a great visual depiction of how fraud occurs. This concept further supports the contention that reducing opportunity should be the key element of counter fraud efforts.
Why Do Fraudsters Commit Fraud Over Other Types of Crime? This article will infuse criminological theory into the fraud environment in order to assist with counter fraud efforts. Enjoy this 2-part article to be continued in the next newsletter! In this first section, we will dive into criminological theories, learning about the concepts and principles regarding criminal behavior. Next week, we will learn how all of this can be applied in an insurance fraud setting.