Page 24 - Turkinsurance Digital Magazine

22 interview

We fight against the fraudulent and

abusive insurance transactions that can

be seen all around the world

Salih Taşyon, Head of Insurance Fraud and Abuse Bureau of Turkey (SİSEB): “We
know that 80 billion USD of total insured losses in USA are fraudulent and abusive
claims. British state that they catch 2.1 billion GBP of insurance fraud and abuse. We

estimate this amount has reached 1 billion TL in Turkey.”

the fight of insurance companies against or-
ganized insurance fraud and abuse. We also
aim to provide an efficient cooperation with
the insurance market; we monitor fraud and
abuse cases together. We file criminal com-
plaints against organizational fraud cases.
We support insurance companies with train-
ings, meetings and visits about how they can
fight against cases of insurance fraud and
abuse. We also provide periodical reports for
insurance companies, helping them compare
themselves with the rest of the market. Most
importantly, we try to manage the percep-
tion of abuse and fraud. We wish to spread
the apprehension that “insurance abuse is a
crime” to he entirety of our society. In ac-
cordance with all these targets, we try to
provide services to all other stakeholders in
the market besides insurance companies, in-
cluding the agents, experts, repair shops and
citizens. We are working integrated with 22
public institutions.

What are the functions of SİSEB?
Could you briefly inform us about the ket; and has extensive knowledge of policy
purpose of SİSEB’s foundation? general conditions, coverage scope and legal One of our functions is our technological side
dimensions. They are constantly in contact where we try to create a difference, use the
SİSEB (Insurance Fraud Bureau of Turkey) with insurance companies. Our colleagues data and detect anomalies through several
was founded by the Insurance Association in this department have studied computer projects. We move together with the insur-
of Turkey in 2015 within the organization- sciences and mathematical engineering; this ance market in all our projects. One of our
al structure of Insurance Information and team analyzes the data, develops analytical functions is to take decisions via commit-
Monitoring Center. It was founded with methods and uses technology to find ways of tees of the Insurance Association of Turkey
the aim of detecting fraud and abuse cases catching insurance fraud and abuse with ex- (TSB) by referring to consultants whenever
that we call organized cases and cannot be isting data. necessary. Training is also very important
detected by the insurance companies using among our institution’s activities. We are
only their own data; in order to prevent the Our legal foundations lay in the aggravat- also working towards developing our suspi-
financial losses in insurance market. We ed fraud clause of Turkish Criminal Law, cious transaction pool.
have 2 units in our organizational structure, and Regulation on Insurance Malpractices
one of which are Fraud and Abuse Inspec- published in the Insurance Law and Official How does SİSEB detect insurance abuse
tion Unit. This unit consists of employees Gazette. We are an organization that aims and fraud? Can you tell us about the re-
that have experience in the insurance mar- to reduce financial losses in the insurance porting pool model?
market and are responsible of coordinating