Eighty-four percent of the professionals said that some of the fraud cases they examine are tied to another industry, particularly those investigating insurance fraud. However, investigators for the government or in health care were less likely to find their cases overlap with another industry.

Mitigation professionals in the insurance (68%) and financial services (64%) industries believe that sharing fraud data within those industries would be helpful in combatting fraud. Other professionals agreed that sharing information outside of their own industry could be very valuable 42% of the time and moderately valuable 33% of the time.

The majority of professionals surveyed (89%) agreed that developing universal fraud descriptors would be very helpful, particularly those in the insurance industry (63%) and those in financial services (61%). 

In addition, a majority of the respondents (81%) said they would consider contributing their fraud outcomes to a shared database if it meant they would receive fraud information from contributors in other industries.

Related: A look at how internal auditors uncover hidden risks

Fraud concerns vary by industry, but claims fraud is the number one issue for insurance professionals. (Photo: Shutterstock)

What kinds of fraud keep investigators up at night?

The study identified several types of fraud that create the most concern for mitigation professionals including:

• Identity theft (49%).
• Data/IT hacks or software fraud (45%).
• Fraud involving employees/agents (37%).
• Claims fraud (34%).
• Misrepresentation/lying on application for services (31%).
• Collusion/organized fraud activity (26%).
• Fraudulent access to benefits (25%).
• Fraud targeting seniors (18%).

Respondents also said they would spend any extra money available on technology (27%) and training (20%) to increase their fraud-fighting efforts. Other areas where they were willing to invest were process improvement (14%), staffing (13%), analytics (12%) and more data (11%).

The mitigation professionals also identified several areas where they see fraud within their customer interactions:

• Account servicing (43%).
• Application/underwriting (33%).
• Claims/reimbursement requests/returns (21%).
• Product marketing (16%).
• Retention (14%).

Study respondents also indicated that almost 75% are using data analytics solutions as part of their fraud mitigation programs, primarily automated business rules, behavioral analytics, predictive modeling and in some cases informal database searches. The full fraud mitigation study is available directly from LexisNexis.