Page 256 - Ebook health insurance IC27

The Insurance Times

9. Vigilance, compliance checks
 Conduct vigilance/surprise audits in operational branches

10. Audits
 Internal audit, risk audit and external audit department may help to detect fraud

11. Enterprise risk and internal control
 Enterprise risk and internal control Dept must oversee all the process of the company

in a comprehensive manner and check whether all processes are available in an
integrated manner.
 Ensure that process gaps are integrated and plugged

12. Control through insurance covers
 Insurance companies themselves may take fidelity guaranteecovers against employees

to reduce the chances of fraud

260 Guide for Health Insurance