Microinsurance Conference Problem statement of fraud 20 60 20 - - PowerPoint PPT Presentation

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Dec 23, 2023 109 likes •231 views

Fraud management in microinsurance November 2016 Microinsurance Conference Problem statement of fraud 20 60 20 Try Perhaps Never How much can we catch? How much does it really save? What will it cost? Reality Reality check Check `

SLIDE 1 November 2016

Fraud management in microinsurance Microinsurance Conference

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Problem statement of fraud Never

20 60 20

Perhaps Try

How much can we catch? What will it cost? How much does it really save?

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Reality Check

Reality check

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Fraud

Learnings: Looks genuine is not enough Fraudsters are tech savvy Complete fake is possible Fraudsters try small (5 days) Flaw: address does not exist Implications: Use local knowledge Check with hospitals – create white list

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Fraud

Learnings: Opportunity makes a thief Case may not feel “wrong” for client (did incur expenses) Flaw: IM doesn’t require stay Implications: Define quality standards for claim documents Decentralise low value controls Centralise high value controls Build expertise Messages to clients

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Why is the balance so tricky to handle? Detect Act Prevent $ saved

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Virtuous circle of Fraud management

Design end-to-end process Segregation of duty Keep ahead of fraudsters Maintain live selection criteria Verify hypotheses with data

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Our Insurance Vision

With micro-insurance, low-income women can mitigate financial distress caused by unexpected events affecting their family’s health. It can protect the first layer of assets they have created as they move out of poverty. We believe that Insurance products can be designed in a way that creates meaningful value to clients and sustainable solutions to insurers.

With the support of and

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For more information please contact: Gilles Renouil Director, Microinsurance at gr@womensworldbanking.org

Twitter: @womensworldbnkg

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