Rapid assistance and critical analysis are two sides of the same coin

An insurance company must provide help when it is needed,
but must also recognise when it is being deceived.

Optimised claims management (illustration, © Jelka Lerche)

“The customer is always right” – Vienna Insurance Group follows this maxim not only when selling products, but also when customers need their insurance the most: when they make a claim. Vienna Insurance Group provides quick and easy assistance at times like these. This implies simple, efficient internal processes, which benefit both the customer and the insurance company itself, as they contribute to cost optimisation.

Preventing insurance fraud is just as important where cost reduction is concerned, since not all reported losses actually occur. For this reason, Vienna Insurance Group made anti-fraud a priority in the year 2016, and plans to use the closed file review method, i.e. follow-up examination of claims that have already been closed, starting in the year 2017.

Reducing fraud

When a claim occurs, it is important for people to be able to trust us. However, we naturally also have to be able to trust that our customers have provided correct information about their claims. This is especially in the interests of the majority of our customers, who have legitimate claims and actually require assistance. Building on favourable experience in Austria, we therefore started an initiative to reduce fraud. Concretely in Poland and Romania in 2016.

The aim is to use a defined process to more quickly identify potential cases of fraud. Previous experience and typical procedures from the past are used to record patterns of fraud in manuals. These manuals are regularly updated and used to train claims processing employees. Cases that raise strong suspicions of fraud are then examined in more detail in a specialised department and rejected if proof of fraud is established. Constant feedback between claims processing and the specialised fraud department plays a key role in this process. It also makes it clear that this initiative is not a one-time measure, but instead a process that is integrated into the Company and regularly controlled, measured and monitored.

The results to date from this initiative are highly promising, and the process of expanding the model to other companies and countries has already begun.

VIG provides local support and creates synergies

Vienna Insurance Group plays a key role when measures are implemented on site in a Group company. It offers an international project team and best practice methodology. In this way, Vienna Insurance Group supports the implementation in each company and ensures that all necessary processes run correctly and knowledge transfer has taken place once implementation is concluded.

This also ensures that associated synergies and economies of scale can be exploited. No Vienna Insurance Group company has to reinvent the wheel in this process.