We would all love to believe that everyone working in insurance is the paragon of honesty and ethical behavior and that it is the outsiders, the criminals, the general bad actors who are committing fraud against the industry. Unfortunately, this simply is not the truth. Although not the norm, insurance industry professionals have been known to participate in fraud schemes, and agent gaming is just one of the ways it happens.
Agent gaming occurs when insurance agents manipulate the details of insurance policies to alter the premium, to improve risk acceptability or to maximize their commissions and key performance metrics. It is a bad practice that can add risk to an insurer’s book of business while leaving a trail of upset policyholders. Despite the severity of the problem and the potential impact on insurers and insureds alike, agent gaming has been difficult to detect and mitigate. Fortunately, insurers have new technology that can help them.