Optimizing Your GRC Technology Ecosystem

Most organizations rely on multiple technologies to manage GRC across the enterprise. Optimizing a GRC technology ecosystem aligned with a defined GRC process structure improves risk-informed business decisions and achievement of strategic business objectives. This illustration outlines ways to continuously optimize your GRC technology ecosystem for

  • greater process consistency
  • and development of actionable information.

An integrated GRC technology ecosystem built on common vocabulary, taxonomy and processes enables

  • more accurate and timely reporting,
  • increased reliability of achievement of objectives
  • and greater confidence in assurance with less burden on the business.

Here are just a few of the key benefits:

Process and Technology Alignment

  • Common methods for core tasks, uniform taxonomies, and consistent vocabulary for governance, risk management and compliance across the organization
  • Risk-based actions and controls that ensure timely responses to changed circumstances
  • Standardized GRC processes based on understanding where in the organization each defined process takes place and how data is used in managing risks and requirements
  • Connected technologies as necessary to gain a complete view of the management actions, controls and information needed by each user

Governance Systems to include:

  • Strategy / Performance
  • Board Management
  • Audit & Assurance Tools

Risk Systems to include:

  • Brand & Reputation
  • Finance / Treasury Risk
  • Information / IT Risk
  • External Risk Content
  • Third Party Risk

Compliance Systems to include:

  • Policies
  • Helpline / Hotline
  • Training
  • EHS (Environment Health and Safety)
  • Fraud / Corruption
  • Global Trade
  • Privacy
  • Regulatory Change
  • AML (Anti Money Laundering) / KYC (Know Your Customer)

Enabling Systems to include:

  • Data Visualization
  • Analytics
  • Business Intelligence
  • Predictive Tools
  • External Data Sources

Protective Systems to include:

  • Information Security
  • Data Protection
  • Assets Control

Benefits and Outcomes

  • Enhanced tracking of achievement of objectives and obstacles
  • Connected reporting for board/management/external stakeholders
  • Timely understanding of impact from operational decisions
  • Actionable view of changes needed to meet regulatory requirements
  • Clear action pathways for resolution of issues and process reviews
  • Consistent risk assessments feeding into advanced analytics
  • Improved predictive capabilities to support strategic planning
  • Control testing and audit trails for response to regulators and auditors
  • Greater confidence in assurance with less burden on the business
  • Enterprise-wide, departmental and geographic control standards

OCEG

Tips for Optimization

1. Process Framework

  • Identify tasks appropriate for standardization and schedule implementation across units
  • Assess vocabulary used throughout organization for inconsistencies and establish rules
  • Adjust process model periodically to continue alignment with business objectives and activities

2. Technology Ecosystem

  • Periodically review GRC technologies for gaps and duplication of systems
  • Assess appropriateness of connection of systems for data sharing and user access
  • Maintain a current road map for re-purposing and acquisition of technologies

3. Outcome Management

  • Apply standard processes for resolution of issues and remediation of identified process framework or technology ecosystem weaknesses
  • Enhance reporting capabilities with refined report structure and delivery methods/schedules
  • Ensure all users apply the process framework and understand how best to use the technology

Click here to access OCEG’s illustration in detail

Insurance Fraud Report 2019

Let’s start with some numbers. In this 2019 Insurance Fraud survey, loss ratios were 73% in the US. On average, 10% of the incurred losses were related to fraud, resulting in losses of $34 billion per year.

By actively fighting fraud we can improve these ratios and our customers’ experience. It’s time to take our anti-fraud efforts to a higher level. To effectively fight fraud, a company needs support and commitment throughout the organization, from top management to customer service. Detecting fraudulent claims is important. However, it can’t be the only priority. Insurance carriers must also focus on portfolio quality instead of quantity or volume.

It all comes down to profitable portfolio growth. Why should honest customers have to bear the risks brought in by others? In the end, our entire society suffers from fraud. We’re all paying higher premiums to cover for the dishonest. Things don’t change overnight, but an effective industry-wide fraud approach will result in healthy portfolios for insurers and fair insurance premiums for customers. You can call this honest insurance.

The Insurance Fraud Survey was conducted

  • to gain a better understanding of the current market state,
  • the challenges insurers must overcome
  • and the maturity level of the industry regarding insurance fraud.

This report is a follow up to the Insurance Fraud & Digital Transformation Survey published in 2016. Fraudsters are constantly innovating, so it is important to continuously monitor developments. Today you are reading the latest update on insurance fraud. For some topics the results of this survey are compared to those from the 2016 study.

This report explores global fraud trends in P&C insurance. This research addresses

  • challenges,
  • different approaches,
  • engagement,
  • priority,
  • maturity
  • and data sharing.

It provides insights for online presence, mobile apps, visual screening technology, telematics and predictive analytics.

Fraud-Fighting-Culture

Fraudsters are getting smarter in their attempts to stay under their insurer’s radar. They are often one step ahead of the fraud investigator. As a result, money flows to the wrong people. Of course, these fraudulent claims payments have a negative effect on loss ratio and insurance premiums. Therefore, regulators in many countries around the globe created anti-fraud plans and fraud awareness campaigns. Several industry associations have also issued guidelines and proposed preventive measures to help insurers and their customers.

Fraud1

Engagement between Departments

Fraud affects the entire industry, and fighting it pays off. US insurers say that fraud has climbed over 60% over the last three years. Meanwhile, the total savings of proven fraud cases exceeded $116 million. Insurers are seeing an increase in fraudulent cases and believe awareness and cooperation between departments is key to stopping this costly problem.

Fraud2

Weapons to Fight Fraud

Companies like Google, Spotify and Uber all deliver personalized products or services. Data is the engine of it all. The more you know, the better you can serve your customers. This also holds true for the insurance industry. Knowing your customer is very important, and with lots of data, insurers now know them even better. You’d think in today’s fast digital age, fighting fraud would be an automated task.

That’s not the case. Many companies still rely on their staff instead of automated fraud solutions. 67% of the survey respondents state that their company fights fraud based on the gut feeling of their claim adjusters. There is little or no change when compared to 2016.

Fraud3

Data, Data, Data …

In the fight against fraud, insurance carriers face numerous challenges – many related to data. Compared to the 2016 survey results, there have been minor, yet important developments. Regulations around privacy and security have become stricter and clearer.

The General Data Protection Regulation (GDPR) is only one example of centralized rules being pushed from a governmental level. Laws like this improve clarity on what data can be used, how it may be leveraged, and for what purposes.

Indicating risks or detecting fraud is difficult when the quality of internal data is subpar. However, it is also a growing pain when trying to enhance the customer experience. To improve customer experience, internal data needs to be accurate.

Fraud4

Benefits of Using Fraud Detection Software

Fighting fraud can be a time-consuming and error-prone process, especially when done manually. This approach is often based on the knowledge of claims adjustors. But what if that knowledge leaves the company? The influence of bias or prejudice when investigating fraud also comes into play.

With well-organized and automated risk analysis and fraud detection, the chances of fraudsters slipping into the portfolio are diminished significantly. This is the common belief among 42% of insurers. And applications can be processed even faster. Straightthrough processing or touchless claims handling improves customer experience, and thus customer satisfaction. The survey reported 61% of insurers currently work with fraud detection software to improve realtime fraud detection.

Fraud5

Click here to access FRISS’ detailed Report