Transforming Fraud Detection with New Approaches
Insurance | Op Model Transformation | Change Management
Our client is one of the top five property and casualty (P&C) insurance carriers in the United States, known for their extensive national reach and customer-focused service.
The client needed to redesign and launch the operating model for their Special Investigation Unit (SIU) to enhance operational efficiency and organizational effectiveness, particularly in addressing insurance fraud.
OUR APPROACH
We worked closely with the client’s senior leadership to design a new operating model for their SIU. This work included:
Developing an operations strategy that aligned with the company’s long-term goals.
Transforming the existing operating model to ensure streamlined workflows, better resource allocation, and improved investigation outcomes.
Facilitating organizational change management to ensure the successful adoption of the new model across the enterprise.
OUR APPRENTICESHIP
True to our apprenticeship model, we actively involved the client’s personnel in every step of the transformation:
Client associates initially shadowed our team during the development of the operations strategy and gradually took ownership of key workstreams.
We engaged the client’s team in data analysis, decision-making processes, and implementation planning, which strengthened their ability to lead future transformations independently.
“I learned so much from watching how the Manager and Partner worked and interacted with the Executive Team.”
Director SIU
OUR RESULTS
The new SIU operating model was successfully launched, resulting in significant improvements in investigation efficiency and organizational effectiveness.
Additionally, through our apprenticeship approach, the client’s team gained valuable skills in operational strategy and change management, positioning them to independently manage future transformations. This collaboration laid the groundwork for stronger internal capabilities and long-term success.
OUR RECOMMENDATIONS
Operating Model Redesign
We developed a new operating model for the SIU, optimizing processes to reduce inefficiencies and enhance fraud detection and investigation capabilities.
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Change Management
We provided recommendations on how to implement the new model across the organization, focusing on training, communication, and ongoing support.