Streamlining Insurance Fraud Investigation at American Financial Group
American Financial Group’s Investigative Services department is charged with the pursuit of internal fraud cases within the organization’s many agencies and companies. The investigators (Certified Fraud Examiners), must carefully record, document and report each step of the process, and ensure that the status of each case is kept current. They must track names and individuals connected with each case and compile all available supporting evidence. That evidence may consist of, for example, forged documents, criminal background checks, audio recordings of phone conversations, email correspondence or notes from interviews. From the opening to the closing of each case, numerous form letters and reports must be issued to the appropriate parties to ensure compliance with regulatory demands and law enforcement.
With multiple cases being handled by multiple investigators at any given time, good case management is absolutely critical. Prior to the development of the Comprehensive Case Database (CCDB) by KB3 Technical Systems, the department scrambled to keep track of everything using spreadsheets, collections of specially-named Word documents, voluminous paper folders stuffed in a wall of cabinets, and a rudimentary Access database. There was no unified, centralized, systematic mechanism in place to share data, manage cases and collaborate on investigations. The absence of a cohesive system made it all the more challenging to identify similarities, patterns and connections between past cases that could provide clues regarding the modus operandi of a fraud perpetrator. All the key knowledge was “locked up” in the head of each investigator.
Unlock, Capture, Connect
After a series of interviews, an examination of whatever record-keeping mechanisms were in place, and an analysis of existing practices, the now-unlocked knowledge was captured and incorporated into the new Comprehensive Case Database, designed and developed from the ground up to precisely match the department’s requirements. Now, for the first time, each investigator had access to the full set of documents, data and reports for every case being worked. The new multi-user system, being fully integrated into the local network, laptops and scanning devices, further facilitated tracking and coordination by department management.
Over the past ten years, the case load has significantly increased. The Comprehensive Case Database has been migrated to a powerful server with exceptional security measures in place. Case data of every description is stored and managed through a clean and straightforward user interface. For any given case, every event, every note, every scanned document image or captured website screen-shot, every letter or report, is available for review in seconds. Each investigator packs a synchronized replica of the master database in a laptop computer, ready to hit the road armed with comprehensive case data and the tools needed to collaborate with associates.