Moving the Industry
Forward Against Fraud

From left: Ryan Barker, Senior Project Manager, RGAx; Alan Hobbs, Vice President, Underwriting Services; Mark Dion, Vice President, Strategic Underwriting Innovation, U.S. Facultative Underwriting; Colin DeForge, Executive Director, Fac Exclusive ASAP, Underwriting Services; Bob Gooderl, Executive Director, Administration Oversight, Global Acquisitions.

As long as there is money to be made by withholding, misrepresenting, or falsifying information, preventing fraud will remain a challenge for the insurance industry. In fact, trying to meet consumer demand for faster underwriting and claims processing is opening up entirely new opportunities for fraud. The Coalition Against Insurance Fraud conservatively estimates that fraud costs insurers $80 billion annually across all lines in the U.S. alone.

Fraudsters adapt and innovate – as one scheme is thwarted, a new scheme takes its place. RGA has taken steps to adapt and innovate ahead of the fraudsters, and in 2016 formed the Fraud Specialty Team to focus on this area. Underwriters and claims experts apply technology, data analysis, and practical experience to develop advanced detection and prevention strategies and tools for clients.


Attendees at RGA’s 2016 Fraud Conference – a new record

As an example, RGA launched its Risk Scoring Model (RSM) in 2016 for insurers in India, a market with high levels of fraudulent activity. RSM is a predictive model that employs fraud profiling as the main aspect of its rule set. Using multiple weighted variables, RSM assigns a score within each variable based on historical industry claim experience. A case’s final fraud risk score is then calculated by applying the weighted values.

RGA leverages its position as a leading reinsurer to move the entire industry forward in combatting fraud – from acquisition to claim. The RGA Fraud Conference epitomizes this collaborative, comprehensive approach. The fourth annual event in 2016 welcomed a record number of professionals – underwriters, claims analysts, lawyers, even the U.S. Federal Bureau of Investigation – and covered a range of topics, from cyber fraud trends to analytics-based fraud protection. By facilitating this industry-wide discussion and equipping clients to better detect fraud, RGA is leading the way to a new era of fraud prevention.