How GAINSCO Combats Fraud

Fraud is a persistent problem for insurers, but the tools to fight it are gaining sophistication as well.

Insurance fraud was in the news this week, with Allstate announcing its sixth insurance fraud case of the year and Patriot National releasing information about its role in a workers' compensation fraud scheme.

When speaking with GAINSCO chief claims officer Greg Castleman last month, I took a moment to pick his brain about fraud. What gives you the biggest headache when it comes to fraud, and how are you working to combat it?

We have a heavy concentration of business in Florida, where we have experienced an upswing in first-party medical fraud. That is something that the industry has been experiencing for several years now. To combat this problem, we have invested significantly in fraud-scoring models and other tools, which are leveraged by a team of highly skilled special investigators. GAINSCO has a zero tolerance for fraud, as all insurance consumers suffer when there’s fraud and abuse. GAINSCO is committed to do its part in combating this industry problem.  

For what it's worth, the scheme uncovered by Patriot National also operated in Florida.

Nathan Golia is senior editor of Insurance & Technology. He joined the publication in 2010 as associate editor and covers all aspects of the nexus between insurance and information technology, including mobility, distribution, core systems, customer interaction, and risk ... View Full Bio