EFI Global

Fraud Deterrence and the Critical Work of CSRs

 Thursday, May 20, 2021

 CLM Magazine

When combating insurance fraud, there are three watchwords to keep in mind: detect, deter, and refer. You detect fraud to deter perpetrators, and refer all suspicious activity to your special investigation unit.

Two of these elements—detection and referral—take up the most time during fraud training.

Fraud detection is the focal point during discussions about fraud indicators—or ‘red flags’—because fraud can be addressed and stopped once it is recognized.

Fraud referral is also a mainstay of fraud training because reporting known or suspected insurance fraud is mandatory in most states.

Deterrence, meanwhile, can get lost in the shuffle. It’s easy to skip over that one because deterred fraud is the fraud that never actually happens. When it comes to deterrence, customer service representatives (CSRs) play a key role.