By Hassan Zebdeh, Financial Crime Advisor at Eastnets
How does money laundering happen in insurance?
It’s a complex web of illegal activities mixed with social engineering, identity theft, and other nefarious activities. Examples of the complex nature of financial crimes in the sector are captured by the Coalition Against Insurance Fraud (CAIF).
One recent case involved a money laundering and wire fraud campaign targeting Medicare stakeholders in the USA. The scam involved fraudsters sending fake emails from spoof, but realistic-looking hospitals, to healthcare insurers, requesting reimbursements for faked health provisions.
Health is not the only area of insurance suffering at the hands of fraudsters; the FBI estimates that the total cost of (non-health) insurance fraud is more than $40 billion per year, increasing annual insurance premiums for the average U.S. family by between $400 and $700.
In this context, there are four major trends emerging, which compliance leaders need to be aware of.
1. Insurance platforms and automation
The Covid-19 pandemic drove insurance online, along with its financial sector counterparts. The 2022 Interpol Global Crime Trend Report stated, “Money laundering ranked second among the crime trends most frequently indicated by member countries in the region as posing a ‘high’ or ‘very high’ threat”… “The use of online tools by criminals to perpetrate financial fraud schemes has also rapidly expanded, particularly during the pandemic.”
These online tools are a growing industry trend, with a predicted market value of $169 billion by 2026. Fraudsters abuse online insurance platforms to identify digital methods to propagate money laundering schemes.
A recent survey by Attestiv into insurance claim fraud and AI-enabled media generation found that over 80 per cent of insurers were concerned about tampered digital media being used for insurance transactions.
2. DLT, blockchain, and insurance
A 2002 IAIS (International Association of Insurance Supervisors) report into fintech developments in insurance identified several pros and cons when applying Distributed Ledger Technology and blockchain to insurtech. The IAIS warns that “the use of DLT solutions could also heighten the money laundering/terrorism financing risks that insurance could be exposed to.”
3. Insurance product fraud and money laundering
Products make prizes in the world of the money launderer. Fraudsters look for certain types of life insurance and other high value insurance products to move dirty money and clean it up.
Fraudsters may look for insurance policies that are cash redeemable, ‘investing’ in the policy using illicit funds. At an appropriate time, they surrender the policy for a cash payment given out by a legitimate insurer on a legitimate policy, providing them with clean money.
4. Intermediaries and money laundering
While FinCEN regulations place anti-money laundering (AML) requirements and suspicious activity report (SAR) obligations on insurance companies, these regulations apply only to insurance companies, not to intermediaries such as brokers and agents. However, an insurer is responsible for an AML compliance programme’s overall effectiveness, so intermediary activities must be considered.
Anti-money laundering technologies for the insurance sector
Insurance fraudsters hide money laundering activities in webs of deceit and complex, multi-part transactions. Breaking these advanced solutions down into core areas of focus helps to show how insurance companies can tackle money laundering. Below are some of the compliance monitoring solutions that can be used to protect organisations.
Automated watchlist updates
The use of beneficial owners and other entities to perpetuate money laundering requires a deep interrogation of sanction lists. However, these lists are regularly updated and contain vast amounts of data. Ensuring that these lists are kept up to date is a vital defence strategy, rendering these watchlist checks ineffective.
AML checks
AML checking is becoming increasingly complex in response to sophisticated money laundering chains. As a result, AML tools must utilise intelligent technologies to handle this complexity. The ability for fraud experts to augment their work with AI-enabled behavioural monitoring provides the means to spot anomalous behaviours that signals fraudulent transactions.
Customer due diligence
Insurance fraud is heavily dependent on identity, and verifying an individual’s identity is critical in preventing money laundering. Therefore, customer due diligence must be a fundamental part of an insurance organisation’s anti-financial crime programme.
It seems that fraudsters are always finding new ways to get past regulations. If insurance companies fail to upgrade their security systems, the money laundering threat will continue to grow exponentially.
Time to act
We must not let any more time go by as we watch the fraud rates grow. Companies must prepare for attacks on all fronts and turn the tide of financial crime.
Companies must beat criminals at their own game. As lawbreakers innovate and use technology to sidestep rules and checks, insurers must also turn to new tech. It’s an inevitable game of cat and mouse where compliance leaders need to constantly reinforce their defences.
It may feel like a costly investment to make, but the alternative is an even greater loss in terms of fines, lack of trust and reputational damage. Now is the time to act.
|
