Archive for the ‘Insurance Fraud’ Category
Friday, May 9th, 2008
[Post from Infoglide] More Than “Nice”: Identity Resolution is Core to MDM
“Writing about Informatica’s acquisition of Identity Systems, industry expert Jill Dyche offers a great perspective on MDM. This author of a number of very useful books on MDM, CRM, and data warehousing shared in a recent post that she sees the acquisition by Informatica as a good one for the company and the industry.”
DataFlux Community of Experts: Privacy and Data Governance
“At the recent data governance executive briefings that I participated in with Scott Gidley from DataFlux, one of the examples that came up in conversation regarding data governance was that of data privacy.”
WFAA.com: Organized retail theft rings work stores
“Retailers say organized packs of shoplifters are sweeping shelves clean, then reselling stolen goods on eBay or at flea markets. ‘We have not seen regular shoplifting rise over the last several weeks or months because of inflation,’ said Kroger spokesman Garry Huddleston. ‘What we have seen increase is organized retail crime.’”
Today’s THV: MLK Commissioners Defend Director Linked To Fraud Ring
“The state’s insurance commissioner said last week that the state could pursue charges against DuShun Scarbrough, who began working for the commission in March. Scarbrough has not been charged with a crime, but court papers filed by the state say he received more than $19,000 in false insurance claims for accidents tied to the ring.”
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Posted in E-fencing, Retail, Business Intelligence, Master Data Management, Insurance Fraud, ORC, Daily Link Posts, Identity Resolution, Organized Retail Crime, Loss Prevention | No Comments »
Monday, April 21st, 2008
Softpedia: Nokia Sells Identity Systems to Informatica
“‘After thorough consideration, Nokia decided that Identity Systems’ business has a much bigger potential as part of Informatica since identity resolution is a key part of many data quality and data integration initiatives,’ declared Tom Furlong, SVP, Services & Software, Nokia.”
The Eagle-Tribune Online: Court document alleges how auto fraud scam worked
“Ortega noted that Kaplan had his own guidelines pertaining to the accidents: His rate was $250 apiece. He didn’t want more than three people in any accident vehicle. He also instructed runners to avoid certain insurance companies because their accident investigators tended to be more thorough than other insurers.”
delaware online: Police seek man suspected in DVD theft
“A 24-year-old Wilmington man is wanted by state police for allegedly trying to sell $600 worth of stolen DVDs to a retail store in Brandywine Hundred. State police said Joseph W. Nester, of the 200 block of N. DuPont St., will be charged under a recently enacted statute, ‘Organized retail crime with 2+ previous convictions,’ which makes it a felony for someone with at least two previous convictions to ’steal quantities [of merchandise] that would not normally be purchased for personal use with the intent to re-sell it.’”
Enterprise Systems: Ten Lessons from MDM Early Adopters
“MDM Insight 2008 featured an intimate atmosphere that fostered a rich dialogue among participants and highlighted numerous valuable lessons. Here is a recap of the 10 major lessons learned during our two-day immersion in MDM in Savannah.”
Insurance Journal: Seven Arrested in Calif. for Automobile Arson, Fraud Scams
“‘Insurance fraud is not a victimless crime,’ said Commissioner Poizner. ‘Every Californian pays the equivalent of a $500 tax per year because of insurance fraud. Criminals beware: purposely destroying your vehicle will not result in a paycheck - it will result in jail time.’”
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Posted in Business Intelligence, Master Data Management, Data Quality, Data Management, Retail, Insurance Fraud, Daily Link Posts, Identity Resolution, Organized Retail Crime, ORC, Loss Prevention | No Comments »
Monday, April 14th, 2008
DataFlux Community of Experts: Could Master Data Have A Much Wider Remit?
“There seems to be a lot of debate around about data governance and MDM, return on investment on MDM etc. going on at present. . . . So I thought I would look at what MDM could potentially do for an enterprise and see if it implementing MDM might have wider implications. I was amazed at how long my list of what MDM could potentially integrate with started to get.”
Fraud, Phishing and Financial Misdeeds: eBay/Craigslist praised by Congressman for efforts to curb sales of stolen military equipment on their sites (?)
“Given the organized effort on a lot of auction sites to fence stolen merchandise via some pretty sophisticated methods, it’s not surprising that the GAO found military equipment for sale on the sites. Many have speculated that these sites are used as a means of fencing the proceeds of what is known as organized retail crime. . . . Anne Broache (CNet) writes: By calling Craigslist CEO Jim Buckmaster and eBay government relations chief Tod Cohen to Washington for the hearing, the subcommittee seemed to be preparing to place those executives in the hot seat. But the tone of that questioning was actually quite cordial. At the end of the panel, Tierney even praised the companies for ‘trying very hard’ to keep sensitive military goods off their sites and acknowledged the rules of the road aren’t the most clear.”
philly.com: Former W.Pa. chiropractor sentenced in insurance fraud
“Prosecutors say Detelich submitted fraudulent claims to Highmark Blue Cross/Blue Shield for services not rendered. He then split the payments from those claims with some patients.”
b-eye.com - Business Intelligence Network - Blog: Jill Dyche: Reminder: Fabulous MDM Webcast on Tuesday
“In which Jill reminds her peeps about the webcast she’s doing with TDWI’s Wayne Eckerson, where they’ll recall Lessons Learned from the MDM Insight conference.”
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Posted in Business Intelligence, Master Data Management, Data Management, E-fencing, Insurance Fraud, Daily Link Posts, Organized Retail Crime, ORC, Loss Prevention | No Comments »
Friday, March 28th, 2008
Department of Homeland Security: DHS Begins Collecting 10 Fingerprints from International Visitors at New York’s John F. Kennedy International Airport
“’Quite simply, this change gives our officers a more accurate idea of who is in front of them. For legitimate visitors, the process becomes more efficient and their identities are better protected from theft. For those who may pose a risk, we will have greater insight into who they are,’ added Paul Morris, Executive Director of Admissibility and Passenger Programs, Office of Field Operations, CBP.”
Data Governance and Data Quality Insider: Mergers and Acquisitions: Data’s Influence on Company Value
“In my work with Trillium Software, I have talked to customers who have saved millions in acquisition costs by evaluating the data prior to buying a company. Some have gone so far as evaluation of the overlap between their own customer base and the new customer base to determine value. Why pay for a customer when (s)he is already on the customer list?”
Exchange Morning Post: To Mark Fraud Prevention Month, NCR Adds Two More Security Inks to Its Sales Receipt Paper Roll Line
“Many stores have flexible or ‘no hassle’ return policies which the criminals may exploit by using sophisticated technology to copy and print seemingly authentic-looking counterfeit receipts. The thieves then steal items from the retailer and later return the shoplifted goods along with a fraudulent receipt to the retailer’s customer service centre for a ‘refund’.”
Worcester Telegram & Gazette News: Fraud busters - Competition will turn up the heat on scammers
“The state in 1991 established an insurer-supported Insurance Fraud Bureau, which discouraged the worst abuses. However, it was not until a Lawrence grandmother died in a staged auto ‘accident’ in 1993 that the public became aware of the extent of the fraud — in many cases perpetrated by enterprising scammers working in cahoots with crooked chiropractors.”
b-eye.com - Business Intelligence Network: Deploying the Integrated Customer Database: A Case Study
“The demand for integrated information has created a vendor response that has spawned a market for what many call customer data integration (CDI) or master data management (MDM). . . . The vendors offering customer relationship management (CRM) tools, CDI or MDM capabilities usually focus on facilitating and accelerating data movement from one or more databases or files to another using extract, transform and load (ETL), messaging (message queues), and other capabilities. How are these ’solutions’ meeting the customers’ expectations? In a previous article, I mentioned that data movement increases costs (adds more complexity to the information management environment), information float or delays (whether batch or messaging), reduces semantic value (much semantic value is casted in the context of the existing applications), and significantly increases the opportunity for introducing information defects. Customers are realizing that these ’solutions’ are more focused on attacking the symptoms (e.g., moving data around faster) instead of attacking the root cause (e.g., keeping the information integrated in one place in the first place).”
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Posted in Retail, Business Intelligence, Data Quality, Data Management, Insurance Fraud, ORC, Daily Link Posts, National Security, Federal Government, Organized Retail Crime, Loss Prevention | No Comments »
Wednesday, March 26th, 2008
HometownAnnapolis.com: County police battle rising tide of thefts - Anti-shoplifting programs have been implemented
“Faced with an 11 percent countywide spike in thefts last year, county police officers are trying new techniques to stop thieves and shoplifters in north and west county. . . . County police are analyzing data collected to glean details about hot spots, repeat offenders and high-theft items, said Sgt. John Gilmer, a county police department spokesman.”
CarInsurance.com:Lawsuit Accuses Trio in LV
“Shelley Beeler, a spokeswoman for Allstate’s southwest region, which includes Nevada, said the estimate of fraudulent payments is unknown but is believed to be in excess of $75,000. The case and others like it are brought by the company when evidence of fraud is uncovered, she said. . . . Beeler said fraud can add hundreds of dollars each year to the cost of a consumer’s auto insurance policy. The company has a special investigations unit that continually looks for evidence of fraudulent activity, she said.”
ars technica: Analysis: the Obama/Hillary passport breaches and Real ID [Update: McCain too]
“Presidential hopefuls Barack Obama and Hillary Clinton are currently providing the country with a very public lesson in why the ‘privacy advocates’ who oppose initiatives like Real ID and the executive branch’s domestic surveillance programs should really be called ‘democracy advocates.’ In short, only a full investigation will determine whether Executive Branch contractors had political ends in mind when they inappropriately accessed the passport records of Senators Barack Obama and Hillary Clinton on multiple occasions, but the entire incident shows exactly why citizens’ privacy is critical in a country where citizens compete with one another for control of the government.”
b-eye.com - Business Intelligence Network: The Role of Business Intelligence in Managing Compliance
“Healthcare and biopharma organizations are flush with data. Wouldn’t it be nice if we could instead say that these organizations are flush with information or flush with insights? Certainly these organizations are built upon the back of innovation, but it’s probably safe to say that on the whole their data is, well, a mess. Sure, it’s fine in most areas, but then most areas are isolated from one another – which ensures that identifying and merging diverse data sources will generally be challenging. This makes it difficult to glean insightful information from across the whole of the enterprise’s data. So what can be done?”
advertising practitioner: non-obvious, surprise, reality
“There’s a guy in Las Vegas who builds computer systems and trains them in Non-Obvious Relationship Awareness. The casinos there are regular targets for fraudsters and tricksters, often colluding with employees, hoping to sneak themselves some undetected winnings under cover of the mass of gaming transactions that happen every minute. So these systems have to act incredibly quickly; matching information from employee databases with known lists of bad guys, arrest records, customer information, credit reports and all sorts of publicly available data. They’re looking for non-obvious relationships - like the fact that the guy who’s winning lots of cash on table fourteen shares a cellphone number with the dealer on the adjacent table.”
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Posted in Retail, Business Intelligence, Insurance Fraud, Federal Government, Daily Link Posts, Loss Prevention | No Comments »
Monday, March 24th, 2008
silive.com: Shoplifters turn to the Internet for easy cash
“LaRocca, the National Retail Federation official, said the amount of cash stores recover from civil actions is minimal compared to the costs to protect their goods. So, it’s no surprise merchants want to get back whatever they believe they are entitled to. ‘Retailers should have a right to collect the damages from people stealing from their stores,’ he said. ‘As a consumer, you and I pay for these losses in prices charged in retail stores.’”
The Monitor: Allstate alleges fraud at Valley chiropractic clinics
“One of the nation’s top insurers has sued a group of Rio Grande Valley chiropractic clinics and lawyers over their alleged involvement in a multimillion-dollar fraud ring. . . . ‘Individuals who conduct fraud generally do so because they think that they are digging into the deep pockets of a big insurance company,’ Mellander said. ‘But the reality is they’re not. They’re stealing from you and me.’”
Fraud, Phishing and Financial Misdeeds: OCCRP reports on Eastern European/Eurasian organized crime
“Eastern European/Eurasian organized groups seem to have their hands in a wide variety of organized criminal activity. They are often mentioned when referring to anything from auction fraud to payment (credit/debit) card skimming and computer crimes.”
Homeland Security Watch: REAL ID Showdown Averted?
“DHS granted an extension on Friday to the state of Montana so that it can comply with the REAL ID Act. The only thing is that Montana never asked for an extension. Montana governor Brian Schweitzer made news over his intention to defy the law passed by Congress in 2005. Schweitzer is leading a charge (joined by Maine, South Carolina, New Hampshire, and Oklahoma) to oppose the REAL ID Act and any efforts by DHS to impose penalties for non-compliance.”
RetailWire: Theft Hits Retail in the Bottom Line
“The risk of retail theft has only grown with the introduction of higher priced items in categories such as smoking cessation, OTC analgesics and allergy, electronics, razors, cosmetics and perfumes. The percentage product loss between manufacture and point of sale, or shrinkage, is about two percent of sales and higher. While that may sound low, it means the loss of $31 billion due to theft. What can retailers and manufacturers do to address retail theft?”
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Posted in Insurance Fraud, E-fencing, Retail, ORC, Organized Retail Crime, Daily Link Posts, National Security, Federal Government, Loss Prevention | No Comments »
Friday, March 21st, 2008
[Post from Infoglide Software] Evolving Beyond Similarity Searching and Identity Resolution
“Matching names and other identifying information to present a clearer picture of reality is a core goal of advanced government initiatives like DHS’s SecureFlight program. By knowing who someone is and who they’re related to, agencies can participate in social and business transactions with heightened confidence and efficiency. For example, in terrorist screening, it’s helpful not only to know who the person really is but also whom they know. As Jeff Jonas points out, there were connections between all 19 of the terrorists in the 9/11 attack. But because the bad guys keep getting smarter, the technology and processes to identify them have to keep getting better.”
The State Journal: Fraud Stoppers
“To many people, insurance fraud may seem to be victimless crime if a crime at all. . . . But law enforcement experts and insurance experts say nothing could be further from the truth. In this ‘victimless crime,’ everyone is a victim, they say. ‘Insurance fraud costs every homeowner in West Virginia $300 per year through higher premiums,’ said Vickie Neal, regional director of the National Insurance Crime Bureau, a nationwide nonprofit organization that partners with law enforcement to detect and prosecute insurance fraud. . . . ‘Some of the cases with agents we have to go through months and months of books,’ Cline said. ‘To mine that information and put that data in a form that we can take to prosecutors takes a lot of time and work.’”
Loss Prevention: Leading Retail’s Response to ORC - An Interview With Brad Brekke
“ORC (organized retail crime) is hard to identify and understand if you do not step back, investigate, analyze, and look at data from a broad perspective. Much retail crime occurs at the store level, but ORC occurs across a much broader base than one store. Moving away from theft in the store, there is a lot of selling of stolen goods, including traditional fencing of goods and e-fencing on Internet auction sites. . . . You need data to frame your position because businesses make decisions based on data. Finding it can be difficult, but there is more data available today than there ever was. It is also important to partner either with other retailers through the trade organizations or with law enforcement to bring the data together to determine if it is a big enough problem to assign resources to and, if so, what are the right resources. . . . From what we have seen from our own internal data and from external data, ORC is a serious problem.”
PogoWasRight.org: Second National Fusion Center Conference Held to Foster Greater Collaboration
“More than 900 federal, state, and local law enforcement and homeland security officials attended this week the National Fusion Center Conference here to further the U.S. government’s plans to create a seamless network of these centers.”
Evolution of Security: Update: Bob Screens the Apple MacBook Air
“We were able to get our hands on a MacBook Air and run it through the X-ray in our lab. My suspicions were correct. The MacBook does look completely different than your typical laptop or DVD player.”
TechTarget: DAMA keynote: Survival of the data management fittest
“Blechar laid out a number of best practices data management professionals should embrace to meet the changing information architecture landscape. . . . Adopt master data management (MDM) to further data reuse. Business users want agility, Blechar said, ‘which means when you want to reuse the data, it’s there in a way you can consume it.’ MDM is especially important for federating operational data in real time, he said.”
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Posted in E-fencing, Insurance Fraud, Entity Resolution and Analysis, Retail, Master Data Management, Business Intelligence, ORC, Organized Retail Crime, National Security, Daily Link Posts, Federal Government, Identity Resolution, Secure Flight, Loss Prevention | 1 Comment »
Monday, March 17th, 2008
PogoWasRight.org: Dept. of Homeland Security 2008 Data Mining Report
“From their site: ‘This is the third report by the Privacy Office to Congress on data mining.’”
North Country gazette: Insurance Report: Fraud Arrests Up 17%
“The Bureau reported that most insurance fraud cases are now tracked electronically by means of a web-based case management system that became fully operational in 2007. The system allows insurers to electronically transmit suspected fraud reports to the Bureau and allows Bureau personnel to track investigative tasks and events from initial assignment through closure.”
Data Governance and Data Quality Insider: Data Governance in a Recession
“Talk of a recession may slide your plans for big projects like master data management and data governance onto the back burner. Instead, you may be asked to be more tactical – solving problems at a project level rather than an enterprise level. . . . The good news is that times will get better. If and when there is a recession, we most certainly DON’T want to have to rewire and re-do our efforts later on. If you are asked to become more tactical, there are some things to keep in mind that’ll save you strategic frustration:”
ComputerWeekly.com: Speakers at BCS event unravel data privacy issues
“There has always been a need for information sharing within and across enterprises. The aim of the information system, then, should be to provide the right information, to the right person, at the right time. For this to happen, developers should focus on the whole system rather than just the technology.”
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Posted in Insurance Fraud, Business Intelligence, Master Data Management, Data-Mining, Privacy, National Security, Federal Government, Daily Link Posts | No Comments »
Friday, March 14th, 2008
[Post from Infoglide Software] Fraud Tax Increase
“We recently featured a link to an article titled ‘You may be paying $400 to $600 a year to offset shoplifting costs’. When we coined the phrase ‘fraud tax’ in a previous post, we estimated the cost of both property and casualty insurance and retail fraud combined to be about $600 per household. . . . Apparently, we may need to adjust our figure if retail theft alone costs as much as $600 per person, as is speculated in the article.”
DataFlux Community of Experts: Is MDM the Same as Data Quality?
“I just reviewed a handful of case studies on master data management, and I had the distinct feeling of deja vu. Many of the MDM programs in the case studies centered (of course) on customer data, and even more pointedly, on the matching and linkage aspects of customer data integration. Considering that five years ago (prior to the creation of the term ‘master data management’), these case studies would have been touted as best practices in data quality.”
Evolution of Security: Apple MacBook Airs are Cleared for Takeoff
“I’ve never taken part in the war between Mac & PC users… I’ve used both and I enjoy using both, but I thought surely the TSA wasn’t diving into the digital trenches and waging war against Apple. I know we’re a versatile agency, but I would have to admit this would definitely be mission creep.”
Public Opinion: Thefts of Oil of Olay, other beauty products, on the rise
“In some cases, the people who are stealing aren’t working alone. An investigation into shoplifting in Polk County, Fla., uncovered a multimillion-dollar theft ring, leading to 18 people being charged in January. According to the Ledger newspaper in Lakeland, Fla., $60 million to $100 million in merchandise was stolen, which was then transported to ‘fences’ who resold the products at flea markets and with online auctions, such as eBay. Police began investigating the theft ring after two of its members were arrested for retail theft. A search on eBay revealed more than 1,100 products for sale, with many of them being sold for prices that are considerably less than retail value.”
ZDNet: How an information system helped nail Eliot Spitzer and a prostitution ring
“On the surface, Spitzer’s downfall is a New York tabloid’s dream. . . . But what really snared Spitzer was a money laundering investigation that was flagged by suspicious activity reports (SARs) that banks have to file with the Treasury to surface everything from money laundering to terrorist activity.”
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Posted in ORC, Insurance Fraud, E-fencing, Retail, Organized Retail Crime, Data-Mining, Daily Link Posts, National Security, Federal Government, Loss Prevention | No Comments »
Wednesday, March 12th, 2008
We recently featured a link to an article titled “You may be paying $400 to $600 a year to offset shoplifting costs”. When we coined the phrase “fraud tax” in a previous post, we estimated the cost of both property and casualty insurance and retail fraud combined to be about $600 per household.
In fact, we estimate that the cost of insurance fraud (plus retail fraud) adds up to over $600 per year for every American household, a number we like to call the “fraud tax”.
Apparently, we may need to adjust our figure if retail theft alone costs as much as $600 per person, as is speculated in the article.
“There was this fear that the media would uncover our dirty little secrets,” Doyle said. “But now we want the public to know about it, because they’re paying for it. They pay $400 to $600 a year more for merchandise because of retail theft.” The extra money is not just the cost of markups to cover the losses, but also the cost of insurance, electronic tags and in-store cameras. “All of that stuff comes at a price,” Doyle said. “We want the public to be angry about it.”
If Doyle’s estimate reflects the cost per person for adults and children, then the cost of retail fraud would be $2,400 for a family of four (using the high end of Doyle’s range). Add insurance fraud to that, and you’ve got a nice trip to Disneyland.
If you’ve been a regular reader then you know that there’s an existing solution for both retail fraud (including organized retail crime and e-fencing) and insurance claims fraud. If more companies instituted identity (or entity) resolution software, fraud losses could be greatly reduced.
So are you “mad as hell and not going to take this anymore”? Or do you see the fraud tax as just the price of admission so to speak? Leave a comment and let us know.
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Posted in E-fencing, Retail, Insurance Fraud, ORC, Organized Retail Crime, Loss Prevention | 1 Comment »