Special Investigation Unit Insights
DISCOVER NEW RESEARCH INTO THE PERFORMANCE, EFFECTIVENESS AND CHALLENGES OF SPECIAL INVESTIGATION UNITS AND DISCOVER HOW BETTER INSIGHTS CAN DRIVE PRODUCTIVITY IMPROVEMENTS
During the International Association of Special Investigation Units (IASIU) conference held virtually on September 14 and 15, 2020, Polonious ran a panel discussion with some of the world’s leading investigation professionals. A survey conducted revealed some interesting remarkable results.
Read about the key points below or download the full report.
Almost a third of respondents do not have a system for measuring the effectiveness of the SIU, and about a third of those that do measure effectiveness are not allocating costs.
Around half of respondents do not record the number of false positive referrals regardless of source — whether they come from claims teams or from automated tools.
A significant measure of the contribution an SIU makes to the organisation is ROI — costs versus savings on claims — but few respondents are tracking those reliably.
Limited tracking and reporting of false positives has a detrimental effect, because processes cannot be improved without this information.
Around 80 per cent of respondents measure performance of the SIU by the number of referrals. Number of referrals in isolation limits the ability for the SIU to improve customer service or identify opportunities for automation and must be seen in the context with other measures — especially considering the number of false positives and rejected claims.
Many respondents are taking indirect measures such as training to improve SIU performance.
Looking more closely at productivity can identify faults in the investigation process and improve overall performance of the SIU.
In terms of productivity, most organisations are using broad measures such as cycle time, but not looking at more granular indicators like time per stage.
Less than half of respondents measure the quality of investigations, which means more than half are leaving themselves vulnerable if findings are disputed.
“Automated tools such as analytics engines using predictive analytics, machine learning, artificial intelligence and
rules-based algorithms are employed by 50 per cent of organisations, 60 per cent use fraud hotlines, and 65 per
cent said they seek out cases proactively..”
“Surprisingly, one solitary respondent reported rejecting between 61 and 80 per cent of cases referred by claims units….”
“… of the units that track false positives, almost 40 per cent are not feeding these back into the detection tool, so we would hope that these are not the units receiving 41 to 60 per cent false positives…”
You benefit from using Polonious in so many ways…
More than any other factor, the ability to configure a case management solution to reflect your business process gives you a competitive and organizational advantage.
Faster turnaround times. By allowing users to focus on their core responsibilities and not administration and reporting, they are freed up to work the case and complete it in a timely manner.
Ease of navigation, offering easy to use person, organisation and entity searching, case filtering and deep data and document search functionality users can easily find critical information or cases and take action.
Instant overview of case statuses. Via the dashboard, users immediately get a view of their cases with statuses and key dates identified.
Instant updates. Managers in the office can access the newly added data at the press of a button and share it with internal or external clients.
Reduced administrative effort. Typically Polonious reduces case administration from 10 to 25%.
Guided behaviour via configuration of available actions makes it easy for users to understand what they should do next. Users can easily add updates and enter text, change statuses, upload documents or media, check off completed actions, record relevant metrics like case time, travel time, expenses or mileage traveled, proof entries made by others, record complaints or use the log entry as a basis to create a report.
Available anywhere, anytime, online or offline. Users in the field can update case information directly with any device that can run a browser or the ios or android application then sync back to Polonious when they next have access to the Internet.
Automated case reports. In many cases the reports can be completely automated using data, documents and images added during the investigation process.
Less is more. Users only see the parts of the system relevant to their involvement and only cases that they need to see. Once logged in, the user’s view of the world is dependent on many factors including their role in relation to a case such as as a specialist, supplier/vendor, staff member, manager or auditor, the current status of the case and the business units or organisations they are attached to.
Automated updates keep interested parties aware of the progress of their cases via status updates, emails or text (SMS) messages.