Integrated Platform for Identification and Verification of Insurance Crime

Countries

Policy areas

Tags:
e-servicesfraudfraud identificationfraud preventioninsurance crimesecurity

Organisation name Digital Poland Project Centre

Contact person: Wojciech Szajnar

sekretariat.wszajnar@cppc.gov.pl

The goal of the Project is to create public e-services supporting the prevention of insurance crime, in particular the identification and verification services of phenomena concerning insurance crime. It is implemented by providing access to e-services that enable:

– providing the participants of the insurance market and public institutions with knowledge and tools to actively counteract the phenomena associated with insurance crime,

– creating a secure electronic environment for cooperation between institutions involved in the processes of counteracting insurance crime in the co-creation of identification methods, as well as methods of effective response to criminal incidents,

– increasing the level of knowledge about phenomena related to insurance crime.

UFG has also defined an additional goal – to create e-public services supporting institutions responsible for road safety in achieving their goals.

The objectives of the project are a response to identified social problems, in particular:

– The greater scale of insurance crime and the globalization of criminal phenomena, and thus the need to intensify and take new qualitative actions to protect the interests of insurance market participants and citizens.

– Losses incurred by the injured in transport incidents, e.g. incomplete compensation for losses incurred in the event of communication incidents caused by uninsured owners of motor vehicles.

– Losses incurred by vehicle buyers in the form of a higher price than the real purchase value, due to the lack of information on the actual technical condition of the vehicle.

– Unsatisfactory level of road safety in Poland, well below the level of developed EU countries.

The basic risks to which insurance companies are exposed relate to undue or excessive inflations and benefits. In the field of insurance, the subject of fraud is not only damage to vehicles, but also damage to the person. Currently, there is an upward trend in the number of attempts to obtain benefits with the use of personal claims from liability insurance of a motor vehicle owner through, among others, falsification or preparation of medical documentation for the purpose of obtaining the highest possible compensation.

As part of the work, main beneficiaries of services were identified:

– Entrepreneurs providing services on the insurance market – insurance companies,

– Citizens – as insured, injured, buyers of vehicles,

– Administration and public services – requesting information in the processes of counteracting and combating crime phenomena.

In addition, the needs of project beneficiaries were diagnosed, which was the basis for defining e-services created as a result of the project.

The obligations of the Insurance Guarantee Fund will include the maintenance and development of the system, the administration of the system Integrated Platform for Identification and Verification of Insurance Frauds (application software), defining internal procedures for using the system. UFG will be responsible for the operation and reconstruction of equipment that became the property of UFG in connection with the implementation of the project and oversee the implementation of the provisions of the contracts with the entity providing the equipment. The fund will incur related costs from its own budget. In addition, the appropriate UFG organizational units will be responsible for providing the project's products, disseminating the use of the system in contacts with other cooperating organizations and insurance companies, and raising the employees' own qualifications in terms of methods of using the system. In the scope of monitoring the implementation of result indicators, it is the Fund's responsibility during the project's operation to measure the implementation of result indicators, based on the collected partial data.

The basic source of financing UFG operations are deposits of insurance companies, the amount of which is regulated by the Regulation of the Minister of Finance. The mechanism of determining the amount of the basic source of UFG funding by legally imposed on insurers the obligation to transfer payments in a certain amount secures UFG's financial liquidity (in the case of a threat of loss of liquidity, the obligatory payments are increased). In addition, adequate financial condition was guaranteed by law. Therefore, the examination of the financial situation of the beneficiary in the light of providing him with the possibility of financing the project during its exploitation phase indicates the assurance of durability. In connection with the above, the financial sustainability of the project is proved.

For the implementation of the project, the most important is the UFG entitlement to transfer data to:

- Insurance companies,

- The court or the prosecutor's office

- Police

- Central Anticorruption Bureau

- Internal Security Agency

- The injured in transport events in connection with the damage

The implementation of activities supporting the identification and verification of phenomena related to insurance fraud is carried out by UFG through the creation and use of advanced mechanisms for analyzing the collected data. Thus, the UFG function includes tasks related to maintaining the registry and deliberate processing of data collected therein. The Fund is the only entity legally in Poland, authorized to collect and process data from all insurance companies in one central database. It is also authorized to access information from public registers. This puts UFG in the position of one of the system guarantors of the proper functioning of the insurance market in Poland. UFG's tasks in the field of identification and verification of phenomena related to insurance crime are to combat negative ex ante phenomena and complement actions taken by law enforcement bodies (Police, prosecutors) whose reaction to negative phenomena on the insurance market is an ex post reaction. The value of this project lies in the chance of combining seemingly unrelated objects, which will allow the fastest possible reaction and identification of the crime activities simultaneously protecting all beneficiaries of the system.

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