Tag Archives: coalition against insurance fraud

Coalition Against Insurance Fraud – Lemonade: smart business or soft fraud target

9 Nov

lemonade

Crooks likely to probe the P2P insurer with bogus claims

This is a blog about a blog. It’s also a predictor of things to come.

The new insurer Lemonade thinks it has a winning formula. Get rid of agents and most other personnel. Just digitize policy sales and claims. It’s part of the bigger trend of peer-to-peer firms rapidly sprouting in various consumer sectors.

Dennis Jay wrote about Lemonade last week. I’m so fascinated by the upstart startup’s P2P business model that I had to weigh in with my two cents worth.

Lemonade thinks its formula will lower fraud, blogs board member Peter Diamandis.

Policyholders can have underwriting profits donated to nonprofits they choose. Insurance becomes “a social good, rather than a necessary evil.”

People are less likely to try and bilk Lemonade, Diamandis contends. Why would they defraud the insurer and thus reduce the charity donations?

Many policyholders likely will be kind-hearted, as I see it. They’ll keep applications, renewals and claims sparkling clean for the good of the cause.

Two other classes of insured’s may be less charitable. First are the desperate ones. They’re average, everyday people whose finances are sagging. Maybe their home or SUV is near foreclosure, their bank account nearing empty.

They’ll worry more about saving their own skins than what money Lemonade sends to charity. If they can rifle Lemonade to bail themselves out with false claims, their adrenalin-addled brains will impel them to pounce. They could, for instance, trash their car and claim it was stolen or wrecked in a hit-and-run.

Then there’s another class: the greedy.

Some of the greedy are everyday people. They’re not desperate. Many are just opportunists. Maybe they just want to trade up to a bigger diamond engagement ring, and tell Lemonade that, sorrow of sorrows, it slipped off the wife’s finger at the beach. Or double the cost of a sound system lost in a home fire.

Organized rings are another kind of greedy, often led by dangerous sociopaths. Fraud is their business, a science. They’ll study Lemonade and probe for weaknesses in the application and claims system. Just like many crime rings test brick-and-mortar insurers when plotting staged crashes with mass injury claims.

Professional and amateur criminals look for weaklings to exploit, just like wolf packs stalking elk herds. My bet is they’ll try to infiltrate Lemonade to see how much juice is for the taking.

Lemonade’s elysian P2P concept will appeal to tech-savvy millennials — and provide another choice in the marketplace. Maybe Lemonade will inspire traditional insurers to tighten their own operations if they lose large numbers of customers to its community-minded model.

Meanwhile, this trusting P2P business model likely will be tested to the max on the mean streets. Here’s hoping Lemonade’s leadership grasp this truth, and develops new innovative firewalls to protect the company from some very smart street criminals.