The Profile of a Fraudster
James Bilham
Netfoil :
• Claims database
• Not Fraud
• 220 Million Records
• 20 Million Claims
• Insurers
• Accident Management
Companies
• Engineers
• Credit Hire Organisations
Netfoil ACE :
• Claims defended by Hill Dickinson
• Proven Fraudsters
• 2000 Individuals
Defining Fraud
Defining Fraud
Dictionary:
“Wrongful or Criminal deception intended to result in financial gain”
Defining Fraud
Defining Fraud
The Courts:
Cotton, L.J. Court of Appeal - Peek –v- Derry - 1887
“…where a man makes a statement to be acted upon by others which is
false, and which is known by him to be false, or is made by him recklessly,
or without care whether it is true or false – that is without reasonable
ground for believing it to be true…”
Hill Dickinson – Categorising Fraud
Hill Dickinson – Categorising Fraud
Litigated claims were Fraud or Fundamental Dishonesty has been
pleaded and subsequently proved at Trial
Litigated claims were Fraud or Fundamental Dishonesty has been
pleaded and as a result the claim has been discontinued
Litigated claims were Fraud has not been pleaded but the claimant has
been put to strict proof and has not come up to proof at Trial or has
been found to be Fundamentally Dishonest.
Pre litigated files were you have made allegations of Fraud, or that the
claim is tainted by Fundamental Dishonesty and as a result the claim
has gone away.
The Profile of a Fraudster
Interpreting Fraud Data & Identifiying Risk
Interpreting Fraud Data & Identifiying Risk
RAG (+ BLACK)
Web Screening Application
Interpreting Fraud Data & Identifiying Risk
RAG (+ BLACK)
Web Screening Application
Risk Scoring Algarithm
Mass Data Analysis
RAG (+ BLACK)
Web Screening Application
Simple Rules
Immediate results
Identify Risk
Minimal input
Risk Scoring Algarithm
Mass Data Analysis
Mathematical analysis of data
Complex Rules that take time to process
Accurately identify risk
More data that goes in, the better the accuracy
Questions?