SIU Today Summer 2022 - 15

SIU is a place where the Team is as small as the individual investigator
and as large as the entire company or claims organization they work
with. I'll plug here for anti-fraud organizations like the Coalition
and IASIU and their Chapters scattered around the world. IASIU
provides members the opportunity to share experiences and
receive relevant education and professional certifications.
John Trovinger: Tech is a great tool and a big help for us to mine
and measure data. However, humans determine relevancy, what
should be investigated, and how to do it. Tech certainly frees the
investigator and analyst from a lot of the mundane, repetitive,
and burdensome work of the past. I think the advantage of
using anti-fraud tech rests in its ability to help us tell a story
with relevant information so we can make the right decisions to
pay a claim or deny non-meritorious claims. And, we can make
the best use of limited resources by having the right people, at
the right time, in the right place to investigate the right claims.
3
What is the most important bit of
advice you'd give SIU investigators
as they prepare for the next wave of
anti-fraud technology?
Matthew Smith: Be bold, speak out and let your voices be
heard! Not only for yourselves, but for the future of this
great profession and for the sake of future SIU investigators
that come after you. We are at a turning point. Will the SIU
functions of the future be overly reliant on technology and
simply do the " job " as cheaply as possible to meet bareminimum
standards, or will we truly strike the right balance
of using the many great advantages technology brings to
conduct better and more efficient investigations? Today's
leaders will answer that question, but the correct answer will
never be found through silence and acquiescence. Groups like
the IASIU and the Coalition are here to support you, but you,
on the front lines of the fraud fight, must be willing to rise to
the challenge we face and speak out forcefully and truthfully.
An insurer that relies too heavily on technology in favor
of saving money neglects its duty to protect policyholders
from fraud. They are willing to overlook and pass potential
fraud along through higher consumer premiums; this is no
better than the fraudulent contractors, body shops, medical
providers and attorneys they routinely vilify. The actions you
New anti-fraud technology, developed for
investigators, can help investigators perform
more efficient investigations.
take today will define this profession for generations to come.
Let's make our voices heard to make sure insurers find the
right balance between technology and SIU investigators to
fight insurance fraud.
Wade Wickre: Anti-fraud technology, like most technology, is
evolving. Get used to the evolution and let go of what you did
yesterday and embrace what's coming. I had to replace my golf
driver recently because the airline broke my old one. The old driver
worked fine for ten years. When the old driver broke, I bought a
new one with ten years of new technology. I didn't change how I
played the game of golf, but my drives improved going further and
straighter with the new technology in the driver.
New anti-fraud technology, developed for investigators, can help
investigators perform more efficient investigations. Sometimes it
takes finding out that your technology is broken or is not working
to provide the efficiencies that new technology provides.
John Trovinger: Position yourself for future success! There is no
doubt that seizing opportunities to explore and learn new tech will
enhance your skills as an investigator. Rely on your experience in
tandem with using tech to help generate results and build your
career. Anti-fraud tech is on the rise and evolving quickly because it
is a primary driver for carriers to remain competitive in an industry
with tight margins. I recommend finding a trusted tech provider with
a deep track record and industry experts to journey with you. Look
to these subject matter experts to dive deeper with you and share the
possibilities and the efficiencies tech can bring to a modern-day SIU.
IN CONCLUSION
Technological advances have made parts of investigations more
streamlined: background searches can be ran automatically and
contact information can be located at the touch of a button.
Artificial intelligence can quickly process data to flag high risk
claims and transactions like a trend a carrier is seeing, pattern
tracking, link analysis, complimenting manual alerts from
adjusters, and so on. Human SIU investigators are charged with
adapting to best utilize the data available to them while fighting
against budget cuts, SIU compliance requirements, and automated
investigation processes.
Technology is a fantastic tool available to the SIU investigation
community, but it cannot become the only tool used and relied
upon. As we learned here, humans will always be needed to share
anti-fraud knowledge, determine relevancy of anti-fraud outputs,
and verify the new leads that anti-fraud technology provides. It's
a balance, but one that's needed to adequately fight insurance
fraud. Be on the lookout for our third part of The Future of SIU
in our next issue.
SUMMER 2022 | SIU TODAY 15
SIU Today Summer 2022

Table of Contents for the Digital Edition of SIU Today Summer 2022
