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Insurance fraud is a global problem. In the U.S. alone, insurance carriers lost over $34 billion in 2017 on fraudulent insurance claims. It’s a global problem with a growing number of technological solutions. Big data analysis and large-scale collaboration are key to fighting insurance fraud.

The insurance industry is increasingly focused on preventing fraud through innovative systems, relying on the assistance of specialized vendors to help accomplish the task. The burden of detecting and reducing fraud, therefore, no longer lies with the individual insurer.

The 2018 FRISS Insurance Fraud Survey reached over 150 industry professionals and shows a clear picture of the current awareness and challenges of fraud detection and mitigation.

Key survey findings show:

  • Increased focus on data quality 
    The quality of a carrier’s data has become increasingly important. 45% of insurers report a challenge with the quality of fraud data collected. In 2016, only 30% of insurers saw this as a major challenge. The main reasons noted were that too little information was available and/or poor-quality information disrupted the process of effective and reliable analysis. There is a growing industry awareness that quality information is essential to improving the customer experience. Making use of good data ensures short acceptance and claim processing times resulting in happier customers. This data must be readily available and consistently reliable.
  • Exchange of information between insurers is vital to stop fraud
    Today’s insurance customers are more apt to request quotes and purchase insurance online. It’s easier and more convenient, and many carriers are now actively encouraging it over traditional phone or in-office visits. Focusing on online interactions makes it more important for carriers to have immediate access to quality data to make smart decisions on who to insure. The problem is that most carriers don’t have access to enough of it. Third party companies can, in theory, pool together publicly available data as well as shared data from other insurance carriers. Shared data includes information about false claims, unreliable repair shops, and health professionals, imagery and information about insured assets. Years ago, this was virtually impossible. Old thinking said data sharing would be bad for competition, however, a third of insurers surveyed now believe it’s an important tool in fighting fraud. Fraud data pools allow insurers to detect and prevent fraud quicker and more accurately – a benefit to all carriers with little competitive impact. While fraud data pools are incredibly useful assets to insurers, companies must ensure they are compliant. Many companies say this is a challenge, especially with the introduction of the European General Data Protection Regulation (GDPR) rules.
  • Keeping systems up to date
    Most insurers now realize the only way to effectively fight fraud is by implementing advanced and evolving technologies. Automated fraud detection is becoming more effective every day, and carriers must keep pace in order to decrease loss ratios. Today, over 60% of insurers utilize automated fraud detection software to enable real-time fraud detection. Those who do enjoy lower loss ratios, healthier portfolios, and more efficient claims investigations. While 86% of insurers believe their current systems are up to date, over half have difficulty maintaining their software. They share frustrations that their internal IT departments are not capable of keeping up and/or have other priorities. Of those surveyed, 43% report difficulty with data integration and are affected by too many false positives, leading to delays in the claims process. Engaging with specialized fraud detection companies virtually eliminates these challenges.

Improvement is still needed

Much progress has been made in insurance fraud and risk detection over the past two years, and insurance companies still believe reducing fraud is both socially and economically important. When it comes to fighting fraud company-wide, 30% still struggle with organizational buy-in. Consistently updated systems working with quality data allow carriers to make good decisions quickly. While industry awareness is growing, there are still many opportunities for improvement.


Author: Ruud Van Gerwen
Source: CoverageR

During her career as a leadership consultant, Nicki Roth has seen countless variations on executive teams—both for good and ill. But regardless of organization size and structure, certain questions about group composition keep floating to the surface for the leaders of these teams. As an executive director, how do you ensure you have the right people, in the proper roles, on your team? Roth recently shared some advice with Bridgespan Partner Kirk Kramer.

Kirk Kramer: What are the key hurdles for executive team leaders who are looking to create highly effective teams? 
Nicki Roth: Understandably, executive directors and their boards often focus on strategy, funding, growth, and impact. Their primary goals are to get strong players in specific roles with clear functional expertise. Over-focusing on those goals, however, can lead to selecting the wrong people. Beyond functional skills, you need to know if these people have management experience and the ability to develop talent or that they can be trained to do so. Also, can they be team players who think strategically and holistically about the organization and its future? If the answer is “no” to any of these questions, then you may need to rethink some of these folks, regardless of their functional talents.

Kramer: Can you give us an example?
Roth: Sure. One of my clients, Dana [not her real name] had been the executive director of a small early childhood education nonprofit for 12 years. As the organization grew, she created an executive team. After seven years, the team had stabilized around three key people. There was Jeffrey, a veteran nine-year leader hired as one of the first 10 people at the organization. Dana also promoted Tony, previously head of a key service area, after six years with the organization. Tony was the first person Dana assessed for leadership skills as part of the selection process. Nailah was the newest hire and had come on board after 12 years as a leader at another organization. Dana wanted her to bring in fresh thinking and leadership experience.

Even though Dana kept the group small, she still struggled with the team dynamics. She observed that every time the team was about to break with the status quo, Jeffrey pushed back and derailed the discussion. It was also apparent that Nailah was a more talented leader, and this skill gap contributed to the team not quite coming together.

Kramer: So what did Dana do to address the situation?
Roth: She started by meeting with Jeffrey to develop his leadership skills. When that didn’t help, she hired a professional coach to work with him. Neither approach improved the situation. Meanwhile, his attitude created tension with Nailah, who wondered why Dana had not fired him. And Tony felt torn down the middle trying to placate all parties.

The dilemma that Dana faced is typical of what I see with most nonprofit executive teams. Rather than a group of equally skilled leaders pulling in one shared direction, there is a loosely connected group of functional heads. To reverse this trend, executive directors, with support from their boards, must address critical team composition issues.

Kramer: What are some of the critical issues you frequently see?
Roth: Often, there isn’t enough forward thinkingLeadership team members are often selected for the present but based on the history of the organization. Just because someone has made valuable contributions doesn’t mean they are a leader.

Also, there’s comfort in maintaining the status quo. If an organization’s strategy hasn’t been revisited in more than five years, organizations can find that they keep the current leaders in place without considering whether or not their undertaking the right activities or have the right capabilities to lead the current organization.

Lastly, organizations need to make conscious decisions to ensure diversity on the leadership team. Members ought to mirror the community being served and provide role models for staff. Additionally, the mix of backgrounds, age, gender, and experience creates more robust and stimulating input that aids organizational advancement.

Kramer: What is a good starting point for considering who should be on your executive team?
Roth: Imagining the future and what organizational capabilities need to be developed is a strong starting point for thinking about the executive team composition. Executive directors should identify the leadership skills the organization needs to achieve its strategy. If there is a new strategy, a growth spurt, a significant shift in funding, or simply stagnation, it is vital to step back and assess what competencies and vantage points the leadership team needs in order to meet the challenge.

Doing this doesn’t come naturally to most nonprofits, but it’s worth the hard work of identifying and learning necessary leadership skills.  A comprehensive discussion and inventory of required leadership traits provides two things: focus on what it will take to achieve the goals and a path for leadership and talent development.

Once you’ve identified the skills the organization needs, you can assess how many and what new leadership roles emerge. Does a new focus on fundraising mean the development director needs to be on the leadership team? Does a slew of new administrative functions mean you need a chief operating officer?

Don’t get stuck on who you currently have or budget constraints or legacy roles. Once you know the roles that you need, you can work with your board to sequence these changes over time to be in sync with long-range plans.

Kramer: What if your current team doesn’t have the right people with the necessary skills to fulfill those roles?
Roth: Looking at the specific individuals on your team and how they might fit those roles comes last. If you have done your analysis, you will form a new outlook on what you need on your team. The team will undoubtedly need to have members who can think systemically, move beyond functional expertise to manage the whole organization, assume greater authority and accountability, engage in broader and more strategic discussions, collaborate effectively with others, represent the organization to external partners, and share the daily challenges of running the place. This clarity will necessitate some tough decisions. Some current team members may no longer be a good fit while others will need to stretch to develop new competencies. As the executive director, it’s your responsibility to meet organizational needs. It may be that you need to take the uncomfortable step of asking someone to leave or create a detailed development plan for someone to build the skills and competencies needed to serve on the executive team.

In the previous example, Dana went through a team composition analysis before she hired Nailah. And when she saw that Jeffrey was remaining an obstacle despite attempts to help him develop necessary skills, Dana had to face the moment she had been avoiding. Jeffrey was not surprised when Dana talked to him about his exit. Even though he was hurt, he said he actually wondered what had taken her so long.


Author: Kirk Kramer
Source: The Bridgespan Group

Most of the news and information you see on the TV news or in the daily newspaper was generated by people just like you. They send information to the media, usually via press releases and personal contact.

And good news from nonprofit organizations like yours shows up on TV or in the newspaper in the same way.

Unless your nonprofit plays on a national stage, you should not worry about trying to crack the New York Times or ABC News. Stick to placing a good story in your local media. After all, you want to catch the eye of supporters who live right down the street.

And, you could end up on the national stage as well.  A well-kept secret is that many national news stories start at the local level. For instance, a national TV network might notice an engaging story on its local affiliate station. They think it would appeal to a bigger audience. Voila! You’re on the national news.

There are two types of news you will want to get out.  One uses news releases — these work best for stories that you wish many media outlets to cover, such as a special event like a charity run, or to announce the appointment of a new CEO. You can write one release and send it to all of your local media outlets.

However, you should direct most of your media work at pitching unique stories to local media and reporters that you’ve cultivated over time.

Journalists love human interest stories, especially when they involve a David and Goliath theme. Think about someone overcoming overwhelming obstacles, or a child that was in need that your organization helped.

Those types of stories are just the ones to touch the hearts of potential donors, who still get most of their information about good causes through the traditional media.

Here are some tips for getting your organization noticed by your local media.

    • 01

       Get to Know the Media That Are Most Likely to Cover You

      Male journalist and cameraman on urban sidewalk


      Read and watch the media in your local area. Subscribe to the newspapers and magazines, watch the local news, bookmark media websites, and join any organizations where you are likely to meet reporters and editors (some cities have press clubs that you can join).

      Try to figure out where each news outlet sits on the political spectrum or what topics they seem to like. Public media are likely to be interested in liberal causes, while the local business journal might be more conservative and engaged in a business angle to any story.

      For instance, health reporters or sports reporters may be the ones who would be interested in your news. Then you can send your information directly to them rather than just to the “editor.”

      Don’t forget more specialized reporters such as the society page editor who might be interested in your special event if it involves community leaders. The calendar page editor will want your event listings. Most newspapers also carry a list of volunteer opportunities, so find out who writes those.

      Turnover is frequent in the media too.  So keep your media list up to date by checking to see who’s who at your favorite media outlets. It won’t do any good to send a news release to a specific person if that person has moved on.


    • 02

       Get to Know Reporters and Producers Personally but Don’t Become a Pest

      Worried man sitting on sofa using cell phone


      Start by arranging a short meeting at their papers or TV stations to introduce yourself. Be considerate of their busy schedules and make it brief. Drop off some printed material or personally deliver that press release instead of mailing or emailing it.

      The first time you have a story idea for a particular media outlet, email the reporter or TV producer with your idea and then follow up with a phone call  That might give you an opportunity to start building a relationship.

      However, don’t nag a reporter. One reporter said that there is no need to call to say you’re going to send a press release, then follow up to see if the reporter got the press release.  Also, don’t send reminder emails more than once.  If the reporter hasn’t responded, he or she probably isn’t interested.

      Check with other staff members, volunteers, and board members to see if they know reporters. They could be a relative, a neighbor, or a business acquaintance with many local media personalities. A personal story tip from someone the reporter knows personally will likely carry more weight than a call from the PR person at your charity.

    • 03

       Send Complimentary Copies of Your Publications to Reporters

      Pile of post on office desk, close-up


      Instead of just sending publications out with your mass mailings, send a copy to a reporter with your business card attached. It’s unlikely that a reporter or TV producer will pick up a story idea from your publication, but at least they might become acquainted with what your organization does.

      You can’t just sign up a reporter for your email communications, but once a reporter is interested, he or she will likely subscribe to your email newsletter or follow your organization on social media.

      Send an invitation to your special event to the appropriate reporter. Even if the reporter doesn’t attend, the invitation will remind him or her of you and your organization.

      Try to work in as many informal contacts with the reporter as possible. Eventually, you’ll be remembered.

  • 04

     Keep up With the Personnel Changes at Your Favorite Media Outlets

    Business people with digital tablet talking and planning in office


    People in the media move around frequently. Keeping track is not easy. Develop a media list and keep it up-to-date. You may be able to subscribe to a media list for your region, but it can’t substitute entirely for your own meticulously maintained list.

    Look for reporters on social media and follow them there. Do not pitch reporters that way, though, unless you have some indication that they welcome it. Do that through email, mail, or phone. However, you can keep up with a reporter’s interests by following him on social media. Follow reporters on Twitter and even on LinkedIn.  That is also handy for keeping up with where a reporter is currently working.

  • 05

     Always Give the Media a Good Story

    Female volunteer boxing canned food for food drive in warehouse


    Your information should be new, noteworthy, and relevant to a significant share of the public. Reporters are not interested in yesterday’s news, items that are of interest only internally to your organization, or everyday events.

    Provide reporters with good human interest stories. Invite staff and volunteers at your organization to let you know about good story ideas that you might be able to pitch to the media. The best ideas often come from people who are on the front lines of your organization.

  • 06

     Develop a Virtual Media Kit That Resides on Your Organization’s Website

    website design


    Journalists love it when you have lots of online resources for them.

    Set up a virtual media kit that Includes the history of your nonprofit, its mission and goals, and brief profiles and photos of key staff and board members. Post your recent news releases and an online annual report.

    Set up a gallery of downloadable photos that show your organization in action. And make these free to use. Reporters are often writing quickly and need to meet deadlines. Readily available images will make their day.


  • 07

     Take Advantage of Breaking News Stories to Promote Your Organization

    Television studio


    Smart charities use newsjacking to make their organizations relevant to current events.

    One way to do this is to develop a cadre of “experts” who can speak to the issues your organization addresses. Train these experts (they can be staff members and volunteers) and make them available to reporters when there is a relevant news event.

    Even a hard freeze in my area prompts an interview with the Humane Society on how to protect pets during cold weather and another with the Botanical Gardens about taking care of fragile plants. Think about the things you could be the go-to expert for.

    Track local, national and regional news to see if you can tag along on a larger story. Watch for examples of how other charities do this. Did the governor just announce a cutback in public spending that could affect the people you serve?  Is there explosive national news that affects your organization? Local reporters love to localize a national story, so help them by spotting those opportunities.

  • 08

     Make Yourself Available to the Media at Any Time

    Cropped Image Of Journalists Interviewing Businessman


    Always provide your email address on your press releases and your website contact page. But also include a mobile number where reporters can reach you day or night.

    When you receive a call or a message from a reporter, get back to him or her as soon as you can. Reporters work on deadline and will appreciate your rapid response.

    Even if you can’t be much help to a reporter when he or she is researching a story, provide contacts at other nonprofits who might be able to help. Your cooperation will be remembered and will likely pay off eventually.

  • 09

     Always Thank a Reporter for His or Her Coverage

    Thank You Written On Old Typewriter


    Initially, thank the reporter by email, but also follow up with a handwritten thank-you note. Never underestimate the power of a sincere thanks. Plus, never nitpick over minor inaccuracies. They are not worth your effort, and there is nothing to be gained by irritating a reporter.


Author: Joanne Fritz
Source: The Balance 

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