INSURANCE CLAIMS AND RATE EVASION FRAUD SYSTEM BASED UPON VEHICLE HISTORY

• US 20100094664A1
• Filed: 10/02/2009
• Published: 04/15/2010
• Est. Priority Date: 04/20/2007
• Status: Abandoned Application

• Current Assignee: CARFAX Incorporated (S&P Global Inc.)
• Original Assignee: CARFAX Incorporated (S&P Global Inc.)
• Inventors: Wilson, Richard, Bush, Ian, Ferrell, David, Lackey, David
• Application Number:
  US12/572,723
• Publication Number:
  US 20100094664A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/018 Certifying business or products
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A system and method of identifying warning signs of fraud associated with vehicle insurance transactions is presented. The system and method operate by identifying a vehicle, retrieving vehicle history information about the vehicle and determining if the vehicle history information indicates potential fraud based on factors which show a relationship between said vehicle history information and potential fraud incidents. Inferences related to an insurance claim or quote are made based on the results of the determination.

Claims

1. A computer-implemented method of inferring potential fraud related to a vehicle insurance transaction using an electronic vehicle history database, comprising the steps of:

identifying a vehicle by at least one of receiving an insurance claim on an insurance policy associated with the vehicle or receiving a request for an insurance quote on the vehicle;

obtaining a VIN for the identified vehicle;

using a computing device, retrieving vehicle history information about the vehicle associated with said VIN from an electronic vehicle history database;

using a computing device, determining if the vehicle history information indicates potential fraud based on factors which show a relationship between said vehicle history information and potential fraud incidents related to the claim or the quote request; and

based on the results of said determination, flagging said incidents of potential fraud for further action.

2. The method of claim 1, further comprising:

determining quantitatively whether fraud is likely to be associated with the vehicle or not based on said results of said determination.

3. The method of claim 2, wherein said factors are grouped into a plurality of data groupings according to a predetermined scheme.

4. The method of claim 3, wherein said method further comprises generating a score based upon an overall value of each of the plurality of data groupings and determining a likelihood of fraud based upon the score.

5. The method of claim 4, wherein said score is calculated based on a weighted combination of overall values of said plurality of data groupings.

6. The method of claim 5, wherein said score is the sum of weighted overall values of each of said plurality of data groupings represented as a mathematical equation.

7. The method of claim 3, wherein vehicle history data variables formed within a data grouping are similar.

8. The method of claim 3, wherein vehicle history data variables gathered within a data group are specified by a user.

9. The method of claim 1, wherein the at least one data grouping includes at least one of:

a Value Adjustment Flags data grouping;

a Rate Adjustment Flags grouping;

a Rate Evasion Flags data grouping;

a Potential Fraud Flags data grouping;

a VIN Clone Flags data grouping.

10. The method of claim 1, wherein when flagging calls for further action, launching a fraud investigation into that vehicle'"'"'s history.

11. The method of claim 1, further comprising in said determining step, refusing to insure the vehicle if fraud is indicated.

12. The method of claim 1, wherein if the vehicle was identified in response to an insurance claim, refusing to pay the claim in part or in full if fraud is indicated.

13. The method of claim 1, wherein the vehicle history variables include at least one of:

Title Brand/Total Loss, Accident, Failed Inspection, Odometer Problem, High Mileage, Non-Personal Ownership Type, Out-of-area Service Territory, Stolen, Recently for Sale, High Mileage Lease, Inactive, Extended Period of Inactivity, Multiple Registrations, Exported, and Last Activity Date.

14. The method of claim 1, wherein said determining step comprises determining if there is an indication that a vehicle is leased and an indication that the vehicle is driven more than standard industry norms.

15. The method of claim 1, wherein said determining step comprises determining if there is an indication that a vehicle history report has been acquired within the last 90 days and an indication that the report was requested by a consumer or auto dealer.

16. The method of claim 1, wherein said determining step comprises determining if there is an indication that a vehicle was stolen and that it was not reported as recovered by an authoritative vehicle history source.

17. The method of claim 1, wherein said determining step comprises determining if there is an indication that there is a non-personal ownership record and the record is associated with the current owner.

18. The method of claim 1, wherein said determining step comprises determining if there is a valid registration record and an indication that there is a valid service record and the distance between the service and registration locations is greater than a specified number of miles.

19. The method of claim 1, wherein said determining step comprises determining if there is a value adjustment record.

20. The method of claim 1, wherein said determining step comprises determining if there is an indication that the vehicle has been exported and there is no record after the export that the vehicle has been imported.

21. The method of claim 1, wherein said determining step comprises determining if there are a combination of indications that there is more than twenty-seven months between any of the vehicle history records, that the state requires annual or biannual registration, and that none of the records following the inactivity is a physical presentation.

22. The method of claim 1, wherein said determining step comprises determining if there are a combination of indications that there is not any vehicle history within the last twenty-seven months and the state requires annual or biannual registration.

23. The method of claim 1, wherein said determining step comprises determining if there are a combination of indications that there have been three or more registrations in a thirteen month period, that the title numbers or location from each registration do not match in two or more of the cases, and none of the records following the multiple registrations is a physical presentation.

24. A computer system designed for inferring potential fraud related to a vehicle insurance transaction using an electronic vehicle history database, comprising:

means for identifying a vehicle by at least one of receiving an insurance claim on an insurance policy associated with the vehicle or receiving a request for an insurance quote on the vehicle;

means for obtaining a VIN for the identified vehicle;

means for retrieving vehicle history information about the vehicle associated with said VIN from an electronic vehicle history database;

means for determining if the vehicle history information indicates potential fraud based on factors which show a relationship between said vehicle history information and potential fraud incidents related to the claim or the quote request; and

means for flagging said incidents of potential fraud for further action based on the results of the determining means.

25. The system of claim 24, wherein said means for determining comprises means for determining quantitatively whether fraud is likely to be associated with the vehicle or not based on said results of said determination.

26. The system of claim 25, wherein said factors are grouped into a plurality of data groupings according to a predetermined scheme.

27. The system of claim 26, comprising means for generating a score based upon an overall value of each of the plurality of data groupings and determining a likelihood of fraud based upon the score.

28. The system of claim 27, wherein said score is calculated based on a weighted combination of overall values of said plurality of data groupings.

29. The system of claim 28, wherein said score is the sum of weighted overall values of each of said plurality of data groupings represented as a mathematical equation.

30. The system of claim 26, wherein vehicle history data variables formed within a data grouping are similar.

31. The system of claim 26, wherein vehicle history data variables gathered within a data group are specified by a user.

32. The system of claim 24, wherein the at least one data grouping includes at least one of:

a Value Adjustment Flags data grouping;

a Rate Adjustment Flags data grouping;

a Rate Evasion Flags data grouping;

a Potential Fraud Flags data grouping;

a VIN Clone Flags data grouping.

33. The system of claim 24, wherein when flagging calls for further action, launching a fraud investigation into that vehicle'"'"'s history.

34. The system of claim 24, further comprising in said determining step, refusing to insure the vehicle if fraud is indicated.

35. The system of claim 24, wherein if the vehicle was identified in response to an insurance claim, refusing to pay the claim in part or in full if fraud is indicated.

36. The system of claim 24, wherein the vehicle history variables include at least one of:

Title Brand/Total Loss, Accident, Failed Inspection, Odometer Problem, High Mileage, Non-Personal Ownership Type, Out-of-area Service Territory, Stolen, Recently for Sale, High Mileage Lease, Inactive, Extended Period of Inactivity, Multiple Registrations, Exported, and Last Activity Date.

37. The system of claim 24, wherein said means for determining determines if there is an indication that a vehicle is leased and an indication that the vehicle is driven more than standard industry norms.

38. The system of claim 24, wherein said means for determining determines if there is an indication that a vehicle history report has been acquired within the last 90 days and an indication that the report was requested by a consumer or auto dealer.

39. The system of claim 24, wherein said means for determining determines if there is an indication that a vehicle was stolen, that it was not reported as recovered by an authoritative vehicle history source, and that the vehicle was not physically presented.

40. The system of claim 24, wherein said means for determining determines if there is an indication that there is a non-personal ownership record and the record is associated with the current owner.

41. The system of claim 24, wherein said means for determining determines that if there is a valid registration record and an indication that there is a valid service record and the distance between the service and registration locations >

35 miles, this? leads to a flagging of potential fraud.

42. The system of claim 24, wherein said means for determining determines if there is a value adjustment record.

43. The system of claim 24, wherein said means for determining determines if there is an indication that the vehicle has been exported and there is no record after the export that the vehicle has been imported.

44. The system of claim 24, wherein said means for determining determines if there are a combination of indications that there is more than twenty-seven months between any of the vehicle history records, that the state requires annual or biannual registration, and that none of the records following the inactivity is a physical presentation leads to? a flagging of potential fraud.

45. The system of claim 24, wherein said means for determining determines if there are a combination of indications that there is not any vehicle history within the last twenty-seven months and the state requires annual or biannual registration leads to? a flagging of potential fraud.

46. The system of claim 24, wherein said means for determining determines if there are a combination of indications that there have been three or more registrations in a thirteen month period, that the title numbers or location from each registration do not match in two or more of the cases, and none of the records following the multiple registrations is a physical presentation leads to a flagging of potential fraud.

47. A set of instructions encoded on a computer-readable medium, which when executed by a computer carries out a computer-implemented method of inferring potential fraud related to a vehicle insurance transaction using an electronic vehicle history database, said instructions comprising:

instructions for identifying a vehicle by at least one of receiving an insurance claim on an insurance policy associated with the vehicle or receiving a request for an insurance quote on the vehicle;

instructions for obtaining a VIN for the identified vehicle;

instructions for using a computing device, retrieving vehicle history information about the vehicle associated with said VIN from an electronic vehicle history database;

instructions for using a computing device, determining if the vehicle history information indicates potential fraud based on factors which show a relationship between said vehicle history information and potential fraud incidents related to the claim or the quote request; and

instructions for, based on the results of said determination, flagging said incidents of potential fraud for further action.

48. The instructions of claim 47, further comprising:

instructions for determining quantitatively whether fraud is likely to be associated with the vehicle or not based on said results of said determination.

49. The instructions of claim 48, wherein said factors are grouped into a plurality of data groupings according to a predetermined scheme.

50. The instructions of claim 49, wherein said instructions further comprise instructions for generating a score based upon an overall value of each of the plurality of data groupings and determining a likelihood of fraud based upon the score.

51. The instructions of claim 50, wherein said score is calculated based on a weighted combination of overall values of said plurality of data groupings.

52. The instructions of claim 51, wherein said score is the sum of weighted overall values of each of said plurality of data groupings represented as a mathematical equation.

53. The instructions of claim 49, wherein vehicle history data variables formed within a data grouping are similar.

54. The instructions of claim 49, wherein vehicle history data variables gathered within a data group are specified by a user.

55. The instructions of claim 47, wherein the at least one data grouping includes at least one of:

a Value Adjustment Flags data grouping;

a Rate Adjustment Flags data grouping;

a Rate Evasion Flags data grouping;

a Potential Fraud Flags data grouping;

a VIN Clone Flags data grouping.

56. The instructions of claim 47, wherein when flagging calls for further action, launching a fraud investigation into that vehicle'"'"'s history.

57. The instructions of claim 47, further comprising in said determining step, refusing to insure the vehicle if fraud is indicated.

58. The instructions of claim 47, wherein if the vehicle was identified in response to a request for an insurance claim, refusing to pay the claim in part or in full if fraud is indicated.

59. The instructions of claim 47, wherein the vehicle history variables include at least one of:

Title Brand/Total Loss, Accident, Failed Inspection, Odometer Problem, High Mileage, Non-Personal Ownership Type, Out-of-area Service Territory, Stolen, Recently for Sale, High Mileage Lease, Inactive, Extended Period of Inactivity, Multiple Registrations, Exported, and Last Activity Date.

60. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there is an indication that a vehicle is leased and an indication that the vehicle is driven more than standard industry norms.

61. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there is an indication that a vehicle history report has been acquired within the last 90 days and an indication that the report was requested by a consumer or auto dealer.

62. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there is an indication that a vehicle was stolen, that it was not reported as recovered by an authoritative vehicle history source, and that the vehicle was not physically presented.

63. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there is an indication that there is a non-personal ownership record and the record is associated with the current owner.

64. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there is a valid registration record and an indication that there is a valid service record and the distance between the service and registration locations >

35 miles, leading? leads to a flagging of potential fraud.

65. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there is a value adjustment record.

66. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there is an indication that the vehicle has been exported and there is no record after the export that the vehicle has been imported.

67. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there are a combination of indications that there is more than twenty-seven months between any of the vehicle history records, an indication that the state requires annual or biannual registration, and an indication that none of the records following the inactivity is a physical presentation, leading? leads to a flagging of potential fraud.

68. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there are a combination of indications that there is not any vehicle history within the last twenty-seven months and the state requires annual or biannual registration leads to a flagging of potential fraud.

69. The instructions of claim 47, wherein said instructions for determining comprise instructions for determining if there are a combination of indications that there have been three or more registrations in a thirteen month period, that the title numbers or location from each registration do not match in two or more of the cases, and none of the records following the multiple registrations is a physical presentation leads to a flagging of potential fraud.