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Insider Risk in the Insurance Industry

Posted on: November 13, 2017

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ClearForce is an insider risk management solution designed to protect employees and organizations from insider crimes ranging from fraud and theft to cyber breach and workplace violence

The Challenge

Insider threats from employees and contractors are a major component of cyber risk and workplace crime. Research indicates that more than half of corporate
losses from cyber threats involve insiders who initiate or facilitate these crimes.
Insurance companies and their commercial customers often perform pre-employment background checks to screen candidates and identify negative behavior that could adversely impact their ability to do the job, jeopardize the safety of other employees, or introduce significant business risk. Once hired, rarely are background checks renewed and monitoring of employee behavior is usually limited to their use of technology within the workplace. The same behaviors which may have disqualified someone prior to hiring may occur during employment and most businesses are never aware. There are two principal reasons that ongoing reviews do not happen. One, most companies trust their employees to do the right thing and don’t want to violate that culture of trust with an intrusive view into their personal lives. Second, most companies do not have behavioral information available to them or a business application necessary to receive, process and take appropriate actions.

The Solution

ClearForce solves both challenges by going beyond traditional static point-in-    time screening by enabling continuous event-based alerting of high risk behavior
in and outside the organization. Rather than inefficiently investigating common activity to find suspicious behavior, ClearForce delivers company defined,
event-based alerts of high risk behavior. This enables companies to see behind the façade of troubled employees who may become threats to the organization or other employees, prevent the risk before it materializes, and without intruding on the privacy of their workforce.

Any criminal conduct by employees may directly represent a risk to the business or fellow employees, and based on severity, will likely result in immediate internal investigation. Conversely, the rapid acceleration of revolving debt, monthly payments exceeding income, or defaulting on a mortgage may be much less obvious but also signal high levels of personal stress and risk. These often unforeseen changes in an employee’s financial situation can lead to employees making bad decisions that could go undetected for a prolonged period. With ClearForce’s early identification of such situations, company management and HR can intercede and provide the necessary training, counseling or support to prevent the employee from slipping into an unrecoverable condition and becoming an insider risk.

Once a potential risk is identified, ClearForce provides an operationally efficient, EEOC and FCRA compliant and bias-free workflow to take appropriate action. ClearForce operates with 100% employee consent, ensures a non-judgmental, policy-driven, standardized process with pathways for the employee to review, correct or challenge inaccurate or incomplete information. ClearForce’s role-based architecture automates checks and balances and provides initial anonymity of alerts to protect against personal bias or favoritism. ClearForce pre-defines policies that are fully configurable and can be adjusted based on organizational functions, employee roles, or a desired level of alerting within the organization.

Additionally, ClearForce offers an optional automated whistleblower functionality to enable members of the workforce to securely and anonymously submit reports of illegal or inappropriate behavior within the workplace in addition to creating peer and self-reporting capabilities for internal HR incidents. External and internal behavioral alerts and incidents for employees are centrally captured, archived, and adjudicated within the system. Therefore, resources needed to research past complaints, respond to legal questions, and report on trends is significantly reduced.

The Insurance Industry   

Personal Lines Insurance Companies (e.g. auto and homeowners) face significant insider risk of theft, fraud, embezzlement, and forgery due to the sheer volume of activity associated with a large number of employees and sales agents and their staff (including direct employees and/or independent contractors) who, through direct consumer engagement (selling policies and financial products) have access to cash, financial transactions and confidential customer data.

Commercial/Business Insurers face similar internal risks and could equally benefit from ClearForce. Their clients also face a variety of other business related risks, i.e. cyber-crime, commercial/financial crime, and wrongful termination. Commercial insurers may advocate or compel the use of ClearForce to their customers as a means of reducing this risk and potentially related premiums.

ClearForce is a patent pending secure cloud-based service that is offered on a subscription basis and requires limited resources to deploy and manage.