GBG Fraud & Compliance Management

Insurance fraud can be committed by either the buyer or the seller of an insurance policy.

The seller may offer policies from non-existent companies, fail to submit premiums, and churn policies to create more commissions. The buyer exaggerate claims, falsify medical history, post-date policies, sell their policy to for cash when they are diagnosed with a terminal disease, or fake their death or kidnapping. We will focus on the buyer insurance fraud in this post.

B2C fraud includes insurance fraud, payment fraud, identity theft, etc. and reviewing claims is so time-consuming and difficult that many insurers do little more than a cursory review on small claims. Fraudsters know this and will file—and win—small claims for losses that didn’t really occur.  

Credit scoring is a statistical analysis performed by lenders and financial institutions to assess a person’s creditworthiness for mortgages, credit cards, and private loans. Credit scoring is used by lenders to decide whether to extend or deny credit.
Traditionally, a person’s credit score determined by credit bureaus is a number between 300 and 850 with 850 being the highest credit rating possible. As new types of lenders and insurers emerge, however, the traditional credit score becomes just one parameter joined with a large variety of alternative data that helps determine a person’s creditworthiness. 

Fraud between companies can interrupt the flow of business and destroy their reputations and it is becoming increasingly difficult to identify and stop criminals from committing fraud: PYMNTS.com’s 2019 yearly report, “Securing B2B Payments,” relates that global markets lost $4.2 trillion in 2019 alone due to fraud. However, machine learning can identify fraud accurately before it has occurred.

In today’s global economy, supply chains include numerous partners, with services and sourcing managed across several organizations and in jurisdictions across the world. Corporations are increasing their use of third-party suppliers in the execution of key strategic imperatives and these third-party operations are becoming larger and more complicated as time goes on. Businesses should upgrade their risk management framework if they don’t want to miss potential profits and saved costs.

Many companies supply goods, loans, and services based on business and trade credit, either invoicing customers for payment at a later date or providing B2B loans. Business credit risk management assists companies with lending decisions based on a client’s financial health as well as other parameters that may indicate how likely they are to pay on time. Providing the right amount of credit will reduce the risk of late payments or defaults, which expose the vendor to financial risk.