Special Investigation Units (SIUs) are key components of any healthy insurance company because of their ability to recognize and fight fraud. However, these units often operate today more or less on their own, separate from the general claims function within insurance enterprises.
Like much of the insurance industry, SIUs are finding ways to adapt to the technology-driven changes that are rapidly transforming the entire anti-fraud field. These units may not be first adopters of new technologies, and therefore may be at risk of losing their edge in the fight against fraud.
To meet these challenges, today’s SIU executives must come to terms with the insurance industry’s changing environment. So many opportunities might open up if claims leaders resolve to find solutions not only to adapt to the present, but to thrive in the future. To do so, it is helpful to break from departmental silos and create a fully integrated claims process with data science, updated analytics and a balanced workforce.
Keys: Data science, analytics
Technology and analytics continue to advance, and are key components to claims investigations. It is important that SIU leaders stay in front of this technology and drive it forward, rather than just try to keep up with current technology.
One suggestion to consider is developing in-house data science teams. They can provide custom support to claims, as opposed to purchasing off-the-shelf products to which other carriers have equal access.
SIUs have historically used rules-based anti-fraud models, or models that required manual combining and reviewing of data. Data scientists now can build predictive anti-fraud models combining claims, fraud and behavioral analytics. This approach can help better identify potentially fraudulent claims and criminal rings that target insurance organizations.
Having these analytics and data teams in-house could help drive SIUs to be more-effective and efficient.
Plan for a balanced workforce
Nearly 30 to 40 percent of the insurance industry workforce will be eligible for retirement in the next five years. To attract much-needed new talent, claims leaders should consider embracing diversity of thought by hiring individuals who “break the mold” of a stereotypical SIU employee.
Instead of only searching for candidates with law-enforcement backgrounds, leaders and hiring managers should think about targeting individuals with backgrounds in leadership, banking, data, security, customer service — and even military experience. A team with a diverse skillset is a team that is often well-equipped for a competitive market.
Become a millennial magnet
I would argue that most of the general public doesn’t know what SIUs do, or even what they are. Because SIUs often are lumped in with claims departments, job seekers may overlook opportunities in the field. SIU leaders should promote the unique qualities of our work — especially with the growing cohort of millennials looking for meaningful and rewarding work.
This would mean finding ways to position SIUs as attractive places to work for young adults, because that’s where our future talent lies. Leaders can do this by creating workplaces that allow for professional growth and educational opportunities. They should also work to develop strong management teams that stay focused on their people first.
When an industry undergoes major changes at a rapid pace, the next steps often are unclear. But like a puzzle, the picture becomes clear when you fit the right pieces in place. As claims leaders, we must challenge ourselves to seek the right tools that will enable SIUs to meet the fraud threats of the future. It’s up to us to make our workplaces more efficient and better equipped.
By staying ahead of technology, implementing data strategies and hiring the strong talent, we can ensure that claims and SIUs are well-positioned to handle the uncertainties of the future.
About the author: Keith Daly is Executive Vice President and Chief Claims Officer of Farmers Insurance.