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Gavin Mascarenhas, Vice President, Claims at Travelers Canada, shares the impacts fraud has on Canadians and how technology is supporting fraud detection. Travelers Canada is part of an industry-leading international team of insurance professionals committed to continuously evolving to meet the ever-changing needs of the industry and consumers. With approximately 1,400 employees across Canada to help customers prepare for, prevent and recover from loss, Travelers Canada’s commitment to outstanding service combined with their comprehensive insurance-based solutions gives individuals and businesses the confidence they need to feel secure.
Équité: For Fraud Prevention Month, what type of insurance fraud would you like to raise awareness about and why?
- GM: There are many types of fraud, and we try to stay on top of them all. The rapid increase in vehicle theft claims has been keeping our investigators busy over the last couple of years. While most auto theft claims are legitimate, we do encounter instances of falsified reports. Other types of auto fraud on the rise that we have seen include the “Re-VINing” and re-selling of stolen vehicles.
Medical fraud also continues to be an issue. This can appear in the form of unscrupulous medical providers billing for services not provided or providing inappropriate or inadequate treatment to customers. Our focus at Travelers is to encourage our customers to work with medical providers they trust and review their paperwork carefully.
Another prominent type of fraud we have been seeing is opportunistic fraud. Common examples of this include enhancing damages or exaggerating claims for the purpose of increasing an insurance payout.
Équité: How have fraud trends changed overtime?
- GM: Criminals continue to get more sophisticated and collaborative. Fraud used to be committed by an individual or single group, but we are seeing more incidents involving more elaborate schemes and on grander scale. A recent trend seems to be the infiltration of institutions by what appears to be organized crime.
Équité: How is technology influencing how you approach fraud detection?
- GM: As technology continues to advance, fraud criminals are also becoming more sophisticated. Travelers Claim leverages the latest technology to help us stay on top of fraud. In addition to its expert staff, our Digital Forensics Library provides us with the tools and services needed to understand the nature of an incident. We have several analytic capabilities that can raise red flags in our systems and prompt us to scrutinize the claims.
Équité: What is your organization doing to protect your clients and the communities they live in from the impacts of insurance fraud?
- GM: Insurance fraud can have several negative impacts on communities. If an insurance company incurs losses due to fraudulent claims, these costs are passed on to policyholders through higher premiums. In some cases, insurance fraud can involve the staging of accidents, intentional damage to property or organized criminal activity, which poses safety risks to individuals.
Travelers Canada protects customers by investing in tools to detect and prevent fraud. We are equipped to deal with the entire claim process in house, which includes investigative services should the need arise. We have invested in several tools and resources that not only help identify fraud, but that allow us to determine the next steps in a fraudulent claim or identify if a crime has occurred.
Insurers are doing more than ever before to protect their customers, and by joining Équité Association, members have access to specific anti-fraud expertise designed to prevent and disrupt insurance crime. Fraud Prevention Month is an annual awareness campaign, which aims to educate Canadians on how to recognize and protect themselves from becoming a victim of fraud. Fraud always has a victim, and criminals typically target those who are the most vulnerable. In collaboration with Équité Association, our members are working to protect Canadians against insurance crimes, a top priority rooted in public safety.
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