Structure Needed for Successful Fraud Fighting Efforts

We all need structure in our lives. Parents provide it for their children, organizations provide it for their employees, and insurance companies provide it for their Special Investigative Unit (SIU) teams. The structure of SIU teams varies by company, but they all have the same objective—to mitigate fraud.

The following are a few critical areas to think about when assessing the fraud fighting structure within your organizations:

  • For the most part, SIU teams are either centralized, with most resources located in one place, or decentralized, and spread out in various geographic locations. The benefits and drawbacks vary between the two and are greatly dependent on an organization’s ability both to leverage technology to share information and knowledge, and to perform investigations remotely.
  • Every organization has reporting channels and SIU teams usually have a clear line of reporting related to suspected fraud within an organization. This is important to minimize confusion when making decisions about the organization’s response to fraud. It all comes down to leadership and setting a vision for the team. I will spend more time on leadership in next week’s blog post.
  • In building on the point above, it is important to identify the level of autonomy employees have when making decisions regarding the fight against fraud. Ideally, organizations should put the experienced employees with access to the best information in a position to make timely decisions, while encouraging collaboration and knowledge sharing with other employees.
  • SIU teams outsource certain tasks to third parties, which is a great tool to bridge the gap from a resource and knowledge perspective. However, there are risks that need to be considered when choosing the tasks to outsource, defining the scope of work, selecting a vendor, and evaluating a vendor’s performance.

The right structure can provide the foundation for success. Once an organization has identified and implemented the structure of its fraud fighting team, it must periodically reassess the structure to ensure the team is cost effective, that knowledge is leveraged, and that team member collaboration occurs in the fight against fraud.

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Topics: Fraud

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