Capability Statement National & International Investigations
Centricity Head Office Suite 9, Level 3 19 Birtwill Street Coolum Beach Qld 4573 Australia Postal Address PO Box 1212 Coolum Beach Qld 4573 Tel: +61 7 5446 1100 Fax: +61 7 5335 1608 24/7: +61 418 88 4950 Web: www.centricityci.com Email: claims@centricityci.com
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About Centricity Centricity's unrivalled national and international expertise has afforded us the opportunity to count many of the world's leading travel, life and general insurers as our valued clients.
Whether investigating a Foreign Death Claim in South America, a helicopter crash in New York or a Travel Claim in Africa, Iran or Iraq, our team continue to achieve and very often exceed our client's expectations.
Centricity has a diversified skill-set encompassing a team of highly qualified and experienced investigators, both nationally and internationally. With decades of experience in handling Foreign Country Investigations, Centricity remain unchallenged in dealing with complex, high value claims in this arena.
National & International Investigations Centricity’s experienced and accredited team of investigators are all connected to our case management application ensuring continuous communication with our field investigators and in-house case managers.
Our investigators handle a range of claim investigations including travel, general insurance and accident, health and life claims. Similarly, Centricity’s international network is recognised for its success and achievements.
In 2011 we investigated a number of complex, high value cases, nationally and internationally including a commercial loss totalling in excess of FJ$15m in Fiji which was declined following a protracted investigation by Centricity which uncovered a range of inconsistencies in the claim. A further commercial loss in NZ resulted in the insured withdrawing a property loss claim in excess of $65,000.
Centricity has also investigated Foreign Death claims in India, Bangladesh, Ecuador, Eastern Europe and Iraq saving our clients in excess of AU$4m over the past 2 years.
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Travel Claims Understanding travel claims and the need to act quickly and decisively has been the cornerstone of Centricity’s success.
Centricity has handled travel claim investigations all over the world and has the unique privilege of training claims teams in the United States, Europe, Scandinavia and the UK and, throughout Australia and New Zealand highlighting emerging and sometimes, sophisticated frauds and, the ever increasing risks confronting travellers in foreign countries.
Our investigations encompass all manner of claims including complex medical and property claims and we have assisted our clients in uncovering complex fraud, suspicious billing activity in medical and dental facilities and false and inflated invoices and fake and manufactured letterheads from suppliers, semi-government authorities and other official entities in foreign countries, all produced by those wishing to embellish their insurance claim.
Our extensive electronic data library houses a wealth of public data including photos, letterheads, documents and intelligence available to our clients as an invaluable cross reference tool.
Centricity’s value added benefits are significant.
Early Intervention Early intervention is critical in any major incidents involving serious personal injuries as well as fatalities. Establishing the facts quickly and accurately brings peace of mind to those directly involved by having a client representative on the ground as soon as is practical. It also assists in determining contribution, liability and potential recovery and by obtaining witness statements and other evidence such as CCTV, it speeds the decision making process for all stakeholders. Our 24/7/365 program provides an immediate response from our team in Australia and our agents based in Asia who continue to provide this outstanding “on call” service.
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Life Claims Centricity has a wealth of experience in investigating Life, Accident & Health claims. At times, these investigations can be complex and often sensitive, requiring discretion and empathy during the investigative process. Centricity has a proven skill-set to ensure every investigation is handled with appropriate diligence and expediency. Centricity has also uncovered fraudulent life and disability claims resulting in substantial savings for our clients.
Regardless of the type of investigation, location or the nature of the inquiry, Centricity works closely with our clients to understand their every need.
As trained investigators we fully explore all avenues of inquiry to ensure a thorough and succinct investigation is undertaken on every case.
We regularly check for the validity of benefits payable through income protection plans with services such as recurring “Alive and Well� checks or formal detailed interviews including those recipients who have relocated to a foreign country.
Additionally, Centricity undertakes surveillance with the capabilities to handle assignments in most countries where this is permitted.
In many cases claimants who are in receipt of regular disability payments or litigated claims and are awaiting a lump sum settlement use an abode in a foreign country as a means of distancing themselves from potential exposure and or surveillance.
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World-Class Technology Centricity's investigation services are supported by InstantAXS, a powerful analytical case management solution designed by us primarily for multi-country claim investigations.
Unlike country centric models, InstantAXS combines data and intelligence from all countries matching fake documents, fictitious clinics, doctors and billing providers, stores and official letterheads to hone in on suspicious and potential fraudulent activity.
This has proven an invaluable tool for our clients around the world and our electronic library houses a wealth of public knowledge and critical intelligence, all available to our clients through InstantAXS.
This intelligence is securely stored in our web-based library for easy AXS by our clients.
Detailed Analytics The analytics produced from InstantAXS not only assists in the evaluation of current claims, it provides data rich metrics for claims managers and underwriters. The following data provides an insight into just some of the reports we provide to our clients on a regular basis.
Withdrawn Claims - 2011
ROI : 7.7 to 1
Fake Documents - 2011
ROI: 12.4 to 1
Forged Documents 2011
ROI: 5.8 to 1
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Claim Losses - Iran
Claim Losses – India
Claimant Address
Claim Losses - Iraq
Claim Losses - Pakistan
General Claim Losses
Dynamic Mapping of Claims Location and Type of Loss
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Overall Travel Claim Losses Investigated by Centricity from April 1, 2011
Conversation Management Conversation Management blends unique psychological interviewing with analytical methodologies to enhance the value of claims assessing and provide an improved customer journey.
Since the introduction of Conversation Management to the insurance industry in the UK in 2001, it has been further refined, drawing on advanced forensic psychology, behavioural psychology and communication techniques to identify fraud trends across various lines of insurance.
The methodology of obtaining information at the outset of a claim rather than weeks or months down the line when it has been flagged as high risk is a best practice which Centricity is introducing.
This structured and decisive process leads to better decisions and the fast tracking of legitimate claims. The Association of British Insurers said in their Anti-Fraud Paper in 2008 that: Conversation Management is seen as a skilled technique for an assessment of a potentially fraudulent claim....the system, if used correctly by a trained interviewer with fraud experience, should rapidly identify both fraudulent policy holders and fast track genuine claimants through to settlement.�
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A survey by a major UK insurer in 2004 stated that more than 45% of household claims screened using Conversation Management were not paid and of the 45%, 33% of claimants withdrew their claims.
RSA UK conducts telephone-based interviews to detect the level of risk within their claims using cognitive techniques, focused on memory recall coupled with behavioural assessment. These techniques are now commonplace across the industry. "We like the cognitive approach. It's very empathetic, non-conformational and leaves the customer feeling very cared about," John Beadle from RSA said. "It's a mixture of psychology and conversation management, including a focus on behavioural traits."
Conversation Management quickly identified the genuine customer allowing for quick and prompt settlement while identifying those high risk cases that require further attention. This ensures your honest customers are settled sooner, delivering stronger brand recognition.
Our in-house claims team has recently completed an advanced in-house training program with our UK partners and our new call centre in Coolum is now handling telephone interviews with client customers. The key advantages for insurers embracing this process include: • • • •
Improved Customer Service Quicker Decision Making and Reduced Claims Cycle Reduced Claims Handling Costs Minimal need for unnecessary External Investigations
Our customised case management application has also been refined to automatically score calls and risk assessments in addition to the preparation of an electronic schedule of loss for review by our clients.
All reports and data are immediately available to our clients via InstantAXS. customised monthly reports on calls, outcomes and savings.
We also provide
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Key Personnel Phil Peart – Managing Director, Centricity Ci Phil Peart has more than 3 decades of insurance investigative experience having lived and worked in the US and China for periods of time. He has travelled trained and worked extensively at an international level throughout Asia, Europe, the Middle East including the UAE, Kuwait and Northern Iraq, South Africa and throughout the Pacific.
He is a regular presenter at the International Travel Insurance Conference (ITIC) and conducts training with many of Centricity’s clients around the world.
Rebecca Gray – Team Leader (Major Injury Claims) Rebecca Gray has been with Centricity for the past two years and continues to provide oversight on many of the injury and medical claims requiring not only domestic, but international investigations. Her background as an investigator with Centrelink and then as Acting Manager and Compliance Advisor with WorkCover Qld has enabled Rebecca to provide strong and purposeful management of these claims.
Rebecca is always available to discuss your needs and concerns on a range of cases, so if you require further information on any matter, please feel free to email her or give her a call.
Contact Rebecca: rgray@centricityci.com
M: 0410 665 289
Vanessa Bond – Senior Case Manager (Travel & General Insurance) Vanessa's early career in banking and then with the WA Police provided her the knowledge and experience required to move into insurance investigations. For 17 years Vanessa worked as a factual investigator, specialising in general insurance, including travel, property, arson and motor vehicle claims and her all-round expertise has added significant value to Centricity's expanding services and operations. Vanessa manages a portfolio of travel claim referrals with an emphasis on property claims within that business unit. Vanessa is working in our Coolum Beach office and can be contacted on the following:
Contact Vanessa: vbond@centricityci.com
T: 07 5446 1100
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Support Team Centricity also has a strong in-house Conversation Management team providing ongoing assistance to our client customers.
Conclusion Thank you for the opportunity to present this overview and we look forward to assisting you with any of your national and international investigative requirements. If you have any questions, please do not hesitate to contact me directly.
Yours faithfully
Phil Peart Managing Director Centricity Ci Pty Ltd Mobile: +61 (0)418 88 4950 Email: ppeart@centricityci.com
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