At present, insurance industry is willing to introduce best practical standards for the current fraud investigators. Some people are finding it quite difficult to cope up with the problems of filing a case as the fraud investigators are making their tasks even more difficult than it seems. It is really hard to let the fraud investigator believe the scenario and the dreadfulness of it. Other than quoting the victim as liar, the investigators are now adding string of questions, irreverent to the topic and have to do nothing with the main accident.
Examine the present norm:
This was just an example of how badly the victims are treated by the fraud investigator. And that’s the main reason for independent monitor of the general insurance industry, Code Governance Committee to examine the use of industrial external investigators for detecting and avoiding paying the fraudulent claims.
There is a growing need to stamp out fraud at present. And this method costs insurers a hefty amount of $2 billion on a yearly scale. It further lights premiums for some honest policyholders. However, according to some consumer advocates; it is the lack of rules, which gave fraud investigator the liberty to bully, intimidate and even threaten the claimants.
New report as presented:
Some recent studies have come across a new report. Here, it was found out that the committee said that when insurers outsourced claims related functionalities to service suppliers like investigators, then the compliance with code of practice turns out to be unpredictable. Therefore, some degree of oversight, as exercised, can prove to be inadequate in some extent.
On the other hand, there are not enough guides available for the fraud investigators while trying to interview the consumers. It has also been found out that some respondents hold the authority to handle complaints when the insurance firms are asked to perform function. On the other hand, there are some other respondents available with great contract with investigators to not align with the code’s said requirements.
More on the recommendation:
The recent study has made 30 recommendations, which even include the interview question to be fair, relevant and transparent. It has even said that the interviews must not exceed more than 2 hours and investigators have the right to assess whether claimants are in need of any special services.
Furthermore, the investigators are asked to offer added support like that from an interpreter. Some guidelines need to be presented for interviewing some minors, like settling a proper age limit. It is further recommended that the industry must develop a proper set of practice standards.
Latest history and some changes made:
Fe years back, the consumer advocacy raised an alarm, stated that investigators were threatening and bullying claimants. Some of them were suffering from health issues and poor English skills. They are interrogated in such a manner that they felt like criminals. There are some incredible panel of services available, and noted for the investigators, as well. It is mandatory for the experts to follow norms properly and follow the new standard of service, before going for the next round of interrogation.
