The second installation of our original series explores the frontlines of identifying insurance fraud and how social media background reporting and analytics tie in with the process. We look at the most significant challenges SIU experts face and how partnering with specialized social media analysts can help improve case outcomes.
Accurate social media intelligence reporting is a revolutionary method of retrieving relevant user insights without the risks of false positives. Furnished with accurate and actionable social media background information, insurance carriers are better equipped to navigate the intricate details of insurance fraud and identify incriminatory discrepancies.
Insurance Fraud: A Lingering Societal Issue
Insurance fraud remains a significant challenge for modern society, with the FBI estimating that the nation loses an estimated $40 billion to fraud cases every year, amounting to roughly $400 to $700 per household.
Respondents from the FRISS Insurance Fraud Report 2020: The Impacts Of COVID-19 On AI And Digitalization In Insurance believe that 18 percent of all claims contain some element of fraud, inflation, or misrepresented value.
There are various reasons for attempting insurance fraud, ranging from an act of revenge against a specific insurance carrier for perceived unfair service to maximizing profits from a claim.
Regardless of the intention, SIU teams often face difficulties detecting fraud cases due to the ever-changing innovation of fraudsters, poor internal data management, and inadequate access to reliable and properly analyzed external data. Accurate social media intelligence can help insurers clamp down on suspected fraud cases with minimal delay, preventing costly claim scams before they occur.
External Data: The Final Piece to a Puzzle
Every insurer faces a certain amount of risk when evaluating a client policy. Access to a vast range of valuable client information from multiple sources enables your insurance company to formulate the best arrangements and premiums according to a person’s profile (while minimizing the risks of fraud).
External data refers to insightful details beyond an insurance company’s available (i.e., collated and digitized) customer information. The compilation of external data provides insurers with a comprehensive breakdown of each policyholder, mitigating risks during underwriting while picking up the earliest indicators for acceptance, revision, or rejection.
In their research, SIU teams often turn to external data to affirm current information or fill in the gaps during a suspected fraud case. While there are many conventional external data suppliers, such as credit data providers and employers, social media has become a leading source of insightful user intel.
Market research shows that social media usage remains one of the most popular online activities, with over 3.6 billion people using it worldwide. Experts predict that the number of active users will increase to 4.41 billion by 2025. Additionally, an average social media user spends almost two and a half hours on platforms per day.
It's no surprise, then, that the social media data of insurance policyholders often contains revelatory user behavior and lifestyle information that SIU teams may apply in expediting fraud detection.
Social Media Background Data: A Game Changer in Fraud Cases
Data from social platforms such as Twitter, Instagram, and Meta (formerly known as Facebook) may shed light on illicit activities. Extracting relevant data can be time-consuming and laborious work for investigators. This time could be better spent on reviewing claims and other client-facing interactions. Most insurance companies do not have the necessary tools or developed skill sets to sift through mountains of online information to expertly extract the most salient points. As a result, adjusters and SIU teams that lack actionable and reliable social media data may miss valuable intel on fraud activities.
For less active social media users, you might discover helpful information from the profiles of family members or close friends. The practical uses of social media data in identifying fraud can involve:
Personal injury claims. In such scenarios, individuals may claim a specific injury that results in lasting bodily or mental harm. However, a quick search on social media might reveal the falsity of the claimed injury, such as the metadata of images that show the individual hiking a mountain or participating in a race.
Medical Malpractice. These situations involve fraudulent medical insurance claims such as permanent disability for a child through an early childhood diagnosis. However, the individual may have fully recovered and is now living an able, healthy life. Accurate social media intelligence can help retrieve online chat logs between the child’s parent and other accomplices in the cover-up, thereby uncovering the fraud.
Worker’s Compensation. Social media background analysts can help identify employees who misreport a workplace mishap that caused injury or loss of income. For example, analysts may discover that an individual who claims complete physical disability resulting from a workplace accident is actively offering services as a judo instructor.
Accurate Social Background Analytics as External Data
The experienced analysts at Social Discovery Corp provide relevant social background data through accurate intelligence. Our team understands that there is no such thing as a one-size-fits-all solution when gathering insights from the complex world of social media.
As such, accurate intelligence combines the speed and accuracy of machine-based algorithms with the contextual expertise of human analysts to help you arrive at quality information without false positives. We work closely with some of the biggest names in claims departments and top insurance providers, developing a proven approach to detecting the earliest signs of fraud.
Additionally, we prioritize customer success, ensuring that SIU teams receive guided support through seamless and transparent collaboration throughout a case. By partnering with Social Discovery Corp, you can provide clients with peace of mind through delivering often elusive social media analytics that validate claims and identify fraud with increased success rates.
The next installment of our series takes readers through the process of underwriting and how social media background reporting can optimize policies for each client.
Contact Social Discovery Corp for a demo on how reliable social media background reporting can benefit your insurance company.