The value of analytics as a fraud tool has become well accepted. The concept has been borrowed from social media platforms like Facebook where users can reach out to past friends who share similar characteristics such as attending the same school, summer camp or workplaces. The case below illustrates that even without sophisticated analytics, social connections can help identify potential fraud cases.
Four Sacramento women are suspected of working together to
defraud auto insurers of more than $37,000, according to the California
Department of Insurance (CDI).
CDI spokesman Dave Althausen said Susan Lee, 24; Angelique Jones, 20;
Angela Medeiros, 40; and, Krystelmaree Marquez, 23 denied knowing each
other but investigators obtained Facebook records and determined the
foursome did know each other as "friends" on the social media website.
CDI spokesman Dave Althausen said according to detectives,
23-year-old Krystelmaree Marquez rented a U-Haul truck Dec. 11, 2011 and
purchased extra insurance protection. She was driving the truck the
next day when she was involved in a collision with a Toyota Yaris
drivien by 40-year-old Angela Medeiros with 24-year-old Susan Lee and
20-year-old Angelique Jones as passengers. The women all claimed
crash-related injuries. Althausen also said Medeiros denied knowing the
other involved parties to insurance company representatives and the
other three women said they didn't know Medeiros.
However, Althausen said investigators obtained Facebook account
records and determined the foursome did know each other as "friends" on
the social media website.
Medeiros, Lee and Jones were arrested on suspicion of three fraud
charges including providing false statements in support of an insurance
claim and participating in a vehicle collision for the purpose of
submitting a false insurance claim. Marquez, who faces the same
allegations, hasn't been located.
Althausen said if convicted of all charges, the suspects face two to five years in state prison and/or a $50,000 fine.
source
As a consumer, I get quite angry about hearing or reading stories about car insurance fraud. After reading articles and blog posts like this one and many others, its not hard to see that these serious cases of fraud harm everyone. Safety compromises and the cost of my car insurance going up…. All quite upsetting. Why don’t regulators be more heavy handed? Seems like Ontario is… http://www.thinkinsure.ca/car-auto-insurance-news/Ontario-Auto-Insurance-Anti-Fraud-Task-Force-Final-Report-Shows-Teeth.html
ReplyDeleteThx,
Jon.
Hi Jon,
ReplyDeleteIn some cases regulators are limited in what they can do with respect to fraud. The Task Force's report recommends that the Insurance Act be amended to expand the powers of the Financial Insurance Commission of Ontario (FSCO) in order it can be more heavy handed. The legislation currently does not provide it with enough tools to adequately combat fraud. However combating fraud by prosecuting fraudsters is only part of the solution. Consumers need to be better informed so that they can recognize suspicious behaviour and avoid me sucked into a scam. Insurance companies also need to develop better tools to detect suspicious claims. The health and legal professions need to weed out bad apples. The Task Force has laid out a blue print and now the government and stakeholders must see that it is implemented.