Analysis of suspicious automobile accident claims at CityPlus Insurance

¶ … CityPlus Insurance

Intelligence seeks to illuminate the unknown. By definition, intelligence analysis deals with highly ambiguous situations. Despite maximum striving for objectivity, the intelligence analyst's own preconceptions are likely to exert a greater impact on the analytical product than in other fields where an analyst is working with less ambiguous and less discordant information.[footnoteRef:1] [1: http://www.au.af.mil/au/awc/awcgate/psych-intel/art5.html ]

In this specific case, CityPlus Insurance has approached with a number of suspicious automobile accident claims. It has gathered and obtained all the relevant information: injured parties, witnesses, vehicle descriptions, license plates, Vehicle Identification Numbers and registered owners, and dates and locations of the incidents.

The injured parties are all claiming soft tissue injuries and filing medical claims through a select group of chiropractors. There also seems to be a particular group of attorneys involved in this process acting on behalf of the injured parties.

In the above situation, to know about the reality of the fraudulent, a curious strategy is required to lead the team to the objectives.

Skills and Assistance to lead the Team

I will bring critical thinking skills, strong ability to research information, and strong communication skills to the team. If there is no coordination, no one will be an effective intelligence analyst.

I will prove myself to be a specialist on team as an experienced analyst. The team members can learn from one another in terms of expressions, strengths and weaknesses. I will take into account their quest for enquiry, their preferences, course of action, commitments, and the obstacles in their path.

I will further try to know about how the team handles challenges. Intelligence analyst may wander into that delicate area of sources and methods, appropriate only for internal audiences.

As the some of the information provided may be important or irrelevant, true or false, and some require further preprocessing before they may be used in analysis.

If for the problem under examination, there is no intelligence available, or the available intelligence is insufficient, the aggressive action in pursuing collection and in energizing collectors will be taken. As an analyst, I will try to know both about the consumer needs and where the intelligence is needed.

Plan

We must have the ability to bring resources for collection of information on important issues. The perception of the general capabilities and limitations of collection systems is necessary for an intelligence analyst. Also, the peers have the psychological perspectives.

As human behaviors change in difficult times, people behave honestly in normal circumstances, may consider the insurance claim a resolution of their financial problems. For insurance market, fraud has been a problem. We consider who, what, why, when and how of investigation and link this to the enquiry. Defeating a fraudulent claim needs careful planning and execution.

Dealing appropriately with the fraudulent claims needs hard facts and evidences. It requires adequacy of evidence, Strategy and tactics, protection of enquiries by legal privilege, conduct of litigation against fraudulent claimants, and application of policy conditions.