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Because insurance fraud results in an enormous cost to insurers, it's important for claims reps to
understand: - ANS ✔✔The resources available in the fight against fraud.
These groups all play a part in the United States' efforts to detect and deter fraud as well as
prosecute and punish those who commit it: - ANS ✔✔Insurers, state and federal governments,
and insurance industry organizations.
Insurers are the first line of defense against insurance fraud because: - ANS ✔✔They're most
likely to detect and report it.
A Special investigation unit S I U is: - ANS ✔✔A division set up to investigate suspicious claims,
premium fraud, or application fraud.
Blockchain is: - ANS ✔✔A distributed digital ledger that facilitates secure transactions without
the need for a third party.
Telematics is: - ANS ✔✔The use of technological devices to transmit data via wireless
communication and GPS tracking.
The Internet of Things I o T is: - ANS ✔✔A network of objects that transmit data to and from
each other without human interaction.
To assist claims reps in detecting and reporting insurance fraud, insurers have created special
investigation units S I U's to: - ANS ✔✔Investigate claims that raise suspicions of fraud.
, Many states now mandate that insurers: - ANS ✔✔Maintain an S I U, as part of their anti-fraud
efforts.
Many S I U personnel have: - ANS ✔✔Law enforcement and investigative experience.
And some have: - ANS ✔✔Criminal justice degrees.
Such qualifications help S I U personnel conduct: - ANS ✔✔The intensive investigations that are
often necessary to substantiate claim denials based on fraud.
Claims reps refer claims to S I U's based on criteria that: - ANS ✔✔Varies by insurer.
Some insurers refer: - ANS ✔✔Every claim that raises suspicions to an S I U.
Others refer claims based on: - ANS ✔✔The extent of the suspected fraud, the prospects of
obtaining proof of the suspected fraud, the size of the claim, or the type of coverage.
Insurers can also help combat fraud by educating: - ANS ✔✔Individual consumers about the
costs associated with insurance fraud.
Some insurers are making efforts to bring awareness of the problem to: - ANS ✔✔Schools,
organizations, and consumer groups.
Technology provides multiple ways to detect fraud, and is used by: - ANS ✔✔Insurers, as well as
organizations that support the insurers.
Databases maintained by insurance-related organizations, such as eye-so, accumulate
information about: - ANS ✔✔Insurance fraud.