Americans tolerate fraud. And many insurance companies, while talking tough, give tacit approval to criminals by paying out fishy claims rather than taking their chances in court.

According to the Coalition Against Insurance Fraud, healthcare fraud alone costs Americans approximately $54 billion a year. What's worse, people believe this type of criminal behavior is justified. In a CAIF survey, two out of three Americans said they tolerate insurance fraud to varying degrees; two out of five Americans want little or no punishment for insurance cheats. They blamed the insurance industry for its fraud problems, citing unfair practices on the business end. At the same time, insurers have given credibility to the notion that fraud is a low-risk venture by deeming some cases too complex and costly to prosecute-arguably encouraging, perhaps passively, the behavior they aim to prevent.

But fraud detection and analysis software packages-or sexier-sounding “cost containment solutions”-are available to guide human intuition, help minimize the total cost of ownership associated with maintaining a special investigation unit (SIU), and in theory, save the insurance industry millions of dollars.

What's Available

Newer technology provides graphic models, color-coding of search results, custom searches, numerous options and support for advanced queries, and hotshot algorithms for solving the most complicated, multi-level questions. These solutions should, of course, install and operate cleanly on databases you already use.