Services of ECRA GMBH

Insurance Fraud

Investigations and audits in the area of insurance fraud

Fraudulent insurance benefits are a social problem, and the cases reported every year are just the tip of the iceberg. The number of unreported cases is many times higher, and the sometimes exorbitantly high losses inevitably lead to an increase in insurance premiums or a reduction in insurance benefits.

Possible triggers

  • Material damage

    • Fire
    • Tap water
    • ED (high-quality household goods)
    • ED (machine parts; IT accessories)
    • Business interruption
    • Vandalism
  • Personal injury

    • KH Haft: concealing personal injury or exaggerating injuries, impairments, loss of earnings (household management damage)
    • General liability: redefining or exaggerating injuries, impairments, loss of earnings (household management damage)
  • Motor vehicle damage

    • KH – provoked, fictitious (paper accidents) and manipulated accident events
    • Fully and partially comprehensive insurance: partial or total loss, fire damage, concealment of drunk and drugged driving, racing events
  • Life/health/insurance

    • Commission fraud
    • Faked death, injuries, illnesses
  • Accident

    • Faked and exaggerated injury findings
    • Self-mutilation
  • Transport and technical insurance

    • cargo theft
    • Data theft

Offer – Services

  • Modern and flexible methods for fraud detection and fraud prevention.

  • Advice on recognising special scams (modi oparandi).
  • Support in saving unjustified claims.
  • ECRA GmbH is supported by a well-founded specialised network, which is trained in investigative and legal matters as well as in special insurance issues.

Insurance Services

Service and support as well as plausibility checks in the event of damage

Not every customer is immediately an insurance fraudster or can be categorised as such. 
The claim and its processing are important points of contact between the insurer and customer and are always an unpleasant matter, which is why claims processing and its speed play an important role.
Various concepts can be developed here that can support or relieve the insurer. For reasons of competitiveness and customer friendliness, an insurer must ensure that its work processes do not become too complex and lengthy. In particular, honest customers should not suffer or even be put off by overly complex regulation. Time-consuming letters, emails or queries as well as long waiting times should be avoided in order to retain honest customers.

This is where the ECRA concept works true to the motto:

Closer customer contact – education and customer loyalty

Our “Insurance Services” division focuses on the economic clarification of claims, preventive measures and the initial assessment of the claim on site.

With an on-site clarification and corresponding dialogue-oriented scheduling, the customer’s needs can be better assessed and questions clarified in advance.

Possible causes

  • High number of claims and time-consuming processing

  • Relief of the specialised departments in the area of claims processing

  • Significant number of previous claims or premium arrears
  • Customer loyalty and service-orientated action
  • Raising quality standards through closer customer loyalty

Our offer – Services

  • Telephone and written contact with the policyholder and claimant.
  • Processing of assigned claims from various lines of business under customer-orientated responsibility and timely scheduling of policyholders and claimants.
  • Damage assessment, clarification of the facts and investigation as well as examination of the damage pattern, damage history and inspection of the damage site.
  • Interview and questioning of possible participants on site and clarification of possible witnesses.
  • Determination and tracking of all facts required for recourse and claims processing.

Investigation

Forensic investigations in the area of white-collar crime

As soon as you learn of a suspected fraudulent act, your next steps are of great importance.
Expectations in dealing with white-collar crime have also increased among employees, business partners and authorities.
Wrong or too slow reactions have a big impact in individual cases and worsen the damage.
A professional investigation team can quickly gain reliable findings. Correct analysis and the right measures are crucial.

We investigate the nature and extent of fraudulent acts, irregularities and breaches of duty.

Possible causes

  • Criminal acts (fraud, theft, embezzlement etc.)
  • Disregard of regulations (money laundering law, data protection laws etc.)
  • (Anonymous) tips.
  • Compliance (violations of internal guidelines or code of coduct).
  • Data protection (data breaches and data leaks).
  • Finance (CEO fraud, capital distortion, fake transactions and wire transfers etc.).
  • Employee fraud (working time fraud, continued pay fraud, post-contractual non-competition clause, undeclared work, expense fraud, unauthorised secondary employment, etc.)

Our offer – Services

  • The goal is to verify or falsify suspicions, clarify facts, identify perpetrators and quantify any damage caused.
  • Consideration of local legislation and data protection regulations in order to maintain their authenticity in court.
  • Assessment of tips and evaluation of whistleblowing systems.
  • Interviewing relevant persons, taking into account employment and data protection regulations.
  • Considering cultural and linguistic characteristics.

Open Source Forensic

Research and analysis of data on the public web

Open Source Intelligence (OSINT) uses information from open, freely available sources to gain relevant insights.
SOCMINT stands for Social Media Intelligence, and this refers to the processing of information from user generated content on social media platforms.

Humant Intelligence (HUMINT) ncludes all forms of interpersonal contact within a network.

ECRA GmbH uses these sources of information in a goal-oriented manner, both via primary and secondary sources.

Possible causes

  • Manipulation of insurance claims with participation of the circle of acquaintances.
  • Formation of phantom companies or buyout of company parts/shells.
  • Relocation of company headquarters and change of location.
  • Disappeared assets (valuables or assets).
  • Counterfeiting of brands and products at home and abroad.
  • Violations of competition rules and clauses.

Our offer – Services

  • Researches to complement internal company special and tort audits.
  • Investigation and assessment of new business relationships.
  • Tracing of publicly available valuables and assets.
  • Asset tracing in the case of moved or concealed assets. Assistance with “asset stripping”.
  • Analysis of market positions and competitive environment.
  • Support in recruitment processes and identification of threats in the context of so-called “blacklists”.
  • Summarize and visually illustrate networks.

Anti-Fraud-Management

Dealing with fraudulent activities as a cross-sectional task

Fraud, money laundering, corruption or embezzlement: white-collar crime causes damages in the billions every year. Companies must always be active to prevent any form of white-collar crime and internal corporate crime.

With the Anti-Fraud Management Assessment, ECRA GmbH can not only support you in evaluating your measures to protect against white-collar crime, but also point out solutions and methods to improve preventive measures.

Fraud Management is understood as a cross-sectional task/responsibility, in which almost all organizational units are to be directly/indirectly involved. Depending on the calculated prognosis of a possible loss, work must be carried out on a departmental basis and measures must be bundled.

An effectively implemented and continuously performed AFM serves to prevent, detect and prosecute deliberate violations.

Possible causes

  • Key factor human being

    • Profiling
    • Workplace Violance
    • Social Engineering and Threat Management
    • Fraud and embezzlement
    • Revealing of trade and business secrets/li>
    • Product and brand piracy
    • Corruption offenses
  • Legal basics

    • Employment law
    • Corporate law
    • Administrative Offences Act
    • Criminal Code
    • Law against unfair competition
    • Data protection and employee control

Our offer – Services

  • Introduction and development of an Anti Fraud Management System with different strategic components.
  • Control, evaluation and analysis of the Fraud Management System through existing performance indicators of the Fraud Prevention Organization. (Basis-measures-action).
  • Fraud auditing support for high-risk corporate units, business units, corporate processes and sub-processes in the area of fraud.
  • Implementation of fraud prevention measures, human resources management, corruption prevention as well as the basics of money laundering.
  • Identification of fraud cases by means of whistleblowing systems and analysis of anonymous tips or forgery detection.
  • Management of fraud cases as a cross-sectional task through various procedures for special investigations, dealing with investigating authorities and determining investigative methods and analytics.

Further training

your employees

Trainings

We provide external training for employees, departments and individual coaching.
Our training offer is currently in preparation.

“There are limits to the human art of deception.”

Sir Arthur Conan Doyle