Identifying Fraud Indicators In Claims ADJUSTED podcast

Content provided by Berkley Industrial Comp. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Berkley Industrial Comp or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.

ADJUSTED »
Identifying Fraud Indicators in Claims

12d ago 44:03

MP3•Episode home

The digital revolution has transformed insurance fraud investigation from cassette tapes to AI algorithms, yet the foundational skills remain surprisingly human. Larry Henning, Senior Vice President of Anti-Fraud and Special Investigations at Allied Universal Services, brings 47 years of investigative expertise to this eye-opening conversation about the evolving landscape of insurance fraud detection.
"God gave you one mouth and two ears for a reason," Henning remarks, highlighting that despite technological advancements, active listening remains the most powerful tool in an investigator's arsenal. He shares a compelling story from early in his career when simply listening carefully revealed a confession that an experienced adjuster had completely missed—a moment that nearly caused him to crash his car in disbelief.
The episode explores how inconsistency across different tellings of the same story serves as the primary red flag for potential fraud. When someone reports an incident to their employer, tells friends, and describes it to medical providers, variations between these accounts warrant deeper investigation. Henning offers practical advice for claims professionals on conducting effective interviews, emphasizing the importance of following up on every person, place, thing, or event mentioned in a claimant's story.
Technology's impact on fraud investigation is examined in depth—from social media algorithms that can search hundreds of platforms simultaneously to geo-intelligence tools capable of identifying witnesses by searching posts from specific locations and timeframes. These digital advances are balanced with traditional "boots on the ground" techniques like locating security footage, creating a powerful combination for uncovering the truth.
Whether you're a claims professional seeking to sharpen your fraud detection skills or simply curious about how investigators separate fact from fiction, this episode offers valuable insights into the art and science of insurance fraud investigation. Subscribe now to hear more conversations with industry experts who are making a difference in the world of claims.

Season 9 is brought to you by Berkley Industrial Comp. This episode is hosted by Greg Hamlin and guest co-host Chris Drake.
Visit the Berkley Industrial Comp blog for more!
Got questions? Send them to [email protected]
For music inquiries, contact Cameron Runyan at [email protected]

Chapters

1. Introduction to Insurance Fraud (00:00:00)

2. Larry's Journey into Fraud Investigation (00:05:42)

3. Recognizing Fraud Indicators (00:10:53)

4. Effective Investigation Techniques (00:18:10)

5. Technology's Impact on Investigations (00:27:10)

6. Social Media and Digital Evidence (00:34:35)

7. State Reporting Requirements (00:41:30)

126 episodes

#Business #Insurance #Claims #Adjuster #Work Comp #Insurance Leadership #MBA #Careers #Berkley Industrial Comp #Workers Compensation #Agent #Innovation #Leadership