Insurance agent gaming and internal audit

Gaming occurs when an agent or broker engages in intentional deception for personal gain, typically financial. Gaming negatively impacts insurers and policyholders in a number of ways. (Photo: iStock)
Gaming occurs when an agent or broker engages in intentional deception for personal gain, typically financial. Gaming negatively impacts insurers and policyholders in a number of ways. (Photo: iStock)

A Miami insurance agent is charged with bilking a finance company out of $276,000 in premium payments with a series of fake applications.

A Long Island broker will serve three to nine years in prison for defrauding several clients and carriers of more than $1 million.

For insurers, the case for advanced analytics has historically focused on the detection of claims fraud. That notion is evolving. Business use cases are expanding beyond the claims department — and for good reason. As the industry focuses on digitization, there is a greater need in the industry to monitor and gain visibility into the activities of employees and agents. Not in a “Big Brother” way but as a means to improve business practices and better serve customers.

Related: Secrets to combating insurance fraud with data analytics

What can advanced analytics reveal that improves the efficiency of employees who investigate and monitor agent performance?

One large insurer recently asked that…

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