Ensure the integrity of submitted claims through comprehensive investigations and accurate underwriting processes.
Insurance fraud is a deliberate act of deception committed by an individual or organization to unlawfully gain benefits or claim payments from an insurance company. It comes in various forms, including filing false claims, inflating claim values, falsifying data, colluding with other parties, and manipulating information during the underwriting process.
Insurance investigations involve collecting and verifying information to confirm the validity of claims, including witness interviews, analysis of supporting documents, field inspections, and detection of potential fraud indicators.
To help prevent claim fraud, Integrity Indonesia provides underwriting investigation services specifically designed for insurance companies. Our consultants will develop investigation programs tailored to each client's needs. The investigation team will verify data and documents, and conduct background checks. This process is designed to identify inconsistent information, manipulation, and hidden risks in the underwriting process.
Integrity Indonesia provides claim investigation services for insurance companies. Investigations are carried out through field fact-finding, document analysis, and objective supporting evidence to assist in the decision-making process, whether to approve or reject submitted claims. With over two decades of experience, our services cover investigations in the following areas:
Uncovering hidden pre-existing conditions, staged or falsified deaths, and claims involving fake insurance policies related to deaths caused by criminal acts.
Identifying whether beneficiaries received payments for medical services that were never rendered or submitted claims for treatments that were not medically necessary.
Investigating suspicious workplace accident claims, including exaggerated conditions, injuries occurring outside of working hours, or claims that do not align with incident reports and medical evidence.
Verifying incidents related to damage, theft, fire, accidents, or legal liability to ensure consistency with facts and supporting documents.
Investigating the involvement of brokers and agents in fraudulent activities.
Interviews with neighbors and community representatives
Employer interviews
Interviews with the patient, family members, or close friends
Directory searches (both online and offline databases)
Witness identification and interviews
Gathering information and medical records
Searches through online and print media (including obituaries)
Collection of photographic evidence
Activity monitoring and observation
Gathering statements in various formats from relevant parties
Verification through official, medical, and forensic institutions
Proven expertise in preventing potential fraud and compliance risks across diverse industries.
Our team consists of professionals, including field teams and analysts, strategically located across various regions.
Presented in a detailed and comprehensive manner, with a rigorous quality control process to ensure accuracy.
Our systems adhere to the ISO framework, ensuring we deliver results that consistently exceed client expectation.
We are committed to top-notch information security, ensuring sensitive data is protected and managed with rigorous controls and practices.
Our company upholds the highest standards of integrity with a zero-tolerance policy towards bribery.
Jl. RS. Fatmawati Raya No.57-B Cilandak Barat Kota Jakarta Selatan, Daerah Khusus Ibukota Jakarta 12430
10/142 (1502B), 15 Floor,nThe Trendy Office Building Soi Sukhumvit 13, Khlong Toei Nuea, Wattana, Bangkok 10110
V Square Unit 5-5-1 PJ City Centre 5-B1-1 Jalan Utara, Bandar Petaling Jaya, 46200 Petaling Jaya, Selangor
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