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Fraudulent Business Interruption claims

As a result of business closures during the COVID-19 pandemic, we have seen a high number of exaggerated and fraudulent business interruption claims, meaning Insurers are at risk of over-compensating policyholders. Our specialist team of forensic accountants and intelligence analysts have the tools and expertise to detect inaccurate information, to help safeguard you from fraud and help you to settle legitimate business interruption claims at the right amount.

What are the issues?

Our team have been supporting Insurer clients with business interruption claims since the first UK lockdown. In this time we have seen anomalies in claims including:

  • Overstated or understated furlough claims
  • Inconsistent or incomplete financial records
  • Claims from multi-site businesses for losses at sites that do not exist or were planned for closure
  • Overstated historic sales records
  • Understated sales achieved during the indemnity period
  • Policy cover that commenced unusually close to the risk period
  • Inconsistencies between financial records and the business' operations
  • Undeclared cost savings.

How can we help?

We are offering a two-phased business interruption fraud detection service for Insurers and Claims Handlers.
Phase one – Uncovering high risk issues

Intelligence screening

When you refer claims to us, we will process the details through our comprehensive claims database, D:cypher, to uncover any suspicions or evidence of previous misconduct connected to the policyholder, its management or key employees.

Forensic review

Meanwhile our forensic accountants will review all of the documents provided in support of the claim(s), to uncover anything that doesn't stack up, such as inconsistencies in the financial records or calculations or explanations.

Risk report

We will use this intelligence to provide a concise risk report highlighting any red flags and identifying any further concerns or areas which may require further information from the policyholder or a more in-depth Phase Two investigation.

Phase Two – Further investigation and quantification

Once our Phase One findings have been considered and any risks appraised, we can conduct a further targeted intelligence review or a full quantification exercise.

Our intelligence team are experts in finding and analysing relevant information from a wide range of sources beyond our proprietary database; including public records, data aggregators, subscription services and social media.

Our experienced forensic accountants can assess the financial elements of BI claims and fairly quantify any true business losses to eliminate the risk of over-compensation.

Pricing

We offer our Phase 1 service at a fixed fee of £750 per claim with the option of flexible pricing for a volume of claims. Phase 2 pricing is bespoke to the particulars of each claim and the intelligence gathered from Phase 1.

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