Case management
Gjensidige fights insurance fraud
Save time
by working in one system
Intuitive GUI
makes a big difference when onboarding new employees
6
months to be up and running
Intro
The general opinion towards insurance fraud is in decline, especially among younger generations in Norway. According to Gjensidige, one in three below the age of thirty approves of reporting excessive damages when filing a claim. This underlines that investigation of potentially fraudulent claims is more important than ever.
In mid-2017, Gjensidige launched a brand-new case management system for investigating insurance fraud. Utilizing no-code software, investigators at Gjensidige can now work in a more structured manner than before, resulting in more resolved cases over time.
“We now have a system that is adapted to our methods, and that can easily change when needed.”
-Ole Hermansen, Head of Investigation Unit at Gjensidige
Challenge
The fight against fraud
Norwegian insurance companies suffer hundreds of millions NOK in losses each year as a result of payouts in fraudulent insurance claims. Rigorous governmental regulations require all actors in the financial sector to report on suspected criminal offenses. Thus, almost all major insurance companies in Norway are rigged with their own unit responsible for investigating and uncovering financial crime.
“Fraud investigation is important to prevent and uncover criminal activity, whether it’s insurance fraud, internal frauds, money laundering, or terror financing,” said Ole Hermansen, Head of Investigation Unit at Gjensidige. “Our investigation unit protects the interests of our honest customers and contributes to our corporate social responsibility. We also avoid undue payments and safeguard our reputation.”
In 2016, Gjensidige understood that their present IT solution for dealing with fraudulent claims was fragmented and outdated. Integrations with core systems were absent, and it was even challenging to assess whether the company met the compliance criteria set by the authorities.
“The previous case management system did not adequately comply with the GDPR regulations,” said Hermansen.
There was a need for streamlining the investigation process, gain control over who can access what data, and establish routines for data cleanup.
Solution
Going no-code with a flexible platform built for the future
In the RFP process that followed, multiple suppliers of case management solutions were evaluated. Off-the-shelf, no-code, and tailored software solutions were all considered. Gjensidige chose to pursue the no-code path, and the contract was eventually awarded to Genus.
“Among other factors, Genus won the bidding process due to its functional completeness,“ said Tor Jan Idland, Insurance Investigator at Gjensidige. “Genus was 100% configurable and straightforward to integrate with our existing software portfolio.”
Just a few months into development, core functionality was in place, enabling key users from Gjensidige to become familiar with and customize the solution. During the development process that stretched 6 months, Gjensidige tailored the solution to their specific needs, designing dashboards, processes, reports, and user interfaces.
Their efforts ultimately ensured that the unit can deliver in compliance; with process support, document handling, reporting, improved data quality across core systems, and much more.
“With the new solution, we have a far more controlled process for storage and deletion of personal data, ensuring our compliance to regulations. In addition, our work processes have become more streamlined and consistent,” said Hermansen.
Result
A streamlined process and happy employees
An intuitive user interface makes a big difference when onboarding new employees and rich document template functionality with data merging frees up time better spent conducting value-adding activities. The semi-rigid and streamlined work process is designed for extracting unambiguous performance statistics.
“We save a lot of time by working in a single system,” said Hermansen. “Previously we had to use several systems to support our processes. We now have a system that is adapted to our methods, and that can easily change when needed.”
Since the introduction of the fraud-investigation solution in 2017, brand new functionality aimed at investigating financial crime has been steadily introduced, making the solution and the Investigation Unit at Gjensidige Forsikring among the best-in-class in terms of fraud investigation, process support, data access control, and compliance.
About
Gjensidige is a leading Nordic insurance group listed on the Oslo Stock Exchange. The company has provided insurance services for more than 200 years.
Gjensidige consists of about 3900 employees and offers insurance products in Norway, Denmark, Sweden, and the Baltic countries. In Norway, Gjensidige also offers banking, pension, and savings. Their operating income was NOK 26 billion in 2018, and total assets were NOK 157 billion.