The Travel Insurance Sickness Bug
RGI Solutions have worked with a number of travel insurers, tour operators and their partners for in excess of 25 years. We undertake screening, evaluation, investigation and we determine the validity of claims from the very minor damaged item in transit through to the much more complex and serious of incidents abroad. From our rich and varied experience in the general claims sector - and more specifically the travel insurance sector, we have seen the patterns, trends and modus operandi of travel insurance fraud develop and evolve.
The insurance industry has come some way over the last decade to grasp the issues relating to fraud, be it the more opportunist attempts or the more sophisticated conspiracies which are part of organised crime activities.
It is quite widely acknowledged that the focus over the past ten years has been mainly on tackling fraud within the motor sector – but what about other sectors? The growth of the ‘Cash for Crash’ phenomenon has generated the establishment of specialist teams primarily focused on motor fraud who have developed sophisticated intelligence led processes and systems to identify potentially fraudulent activities. The establishment of IFED (Insurance Fraud Enforcement Department) combined with improved insurer/police relationships has led to a significant increase in prosecutions and convictions in motor fraud.
The Ministry of Justice reforms have also gone some way to tackling the issues in the motor claims sector and putting barriers in the way of the more dubious claims management organisations.
These developments are to be applauded and welcomed however has there been a by-product of these efforts? We believe there has.
Whilst the industry eyes have been quite firmly fixed on how to combat fraud within the motor sector, claims management organisations have been busy developing other areas of profitable business away from insurers eyes where they can replenish the profits they may stand to lose from motor – and travel insurance claims are certainly one such area.
In the absence of an industry travel claims database, travel insurers, their partners and the self-insured tour operators remain widely exposed to fraud and are largely reliant on the more tenacious front line staff and general claims software to pick up on suspicious claims activity. Lower value claims can flow successfully through insurers systems without generating any questions or examination. As a consequence, dubious claims for sickness are on the rise.
RGI Solutions are acutely aware of the issues travel insurers face whether the claim is a low value loss or damage, relates to a complex overseas illness or injury or indeed relates to the scourge of the all-inclusive buffet and the predictable claims for negligence of the hotel and tour operator, we have a variety of cost effective and innovative solutions to tackle these issues head on. Travel insurance is a sensible necessity and so should be an effective claims validation strategy.
We are confident that in time our industry will develop a similar approach to travel insurance fraud to that seen within the motor sector, however in the meanwhile we believe that it is imperative that insurers, tour operators and their claims partners seek to benefit from the experience and knowledge which is available to them …and RGI Solutions can help.