Fraud Prevention Analytics For Claims Handling
How can you speed up claims handling whilst still ensuring detection of attempted fraud? How can you target your expert resources more effectively for handling difficult cases? Our automated claims acceptance solution is easily integrated into your claims handling process. The system has enabled automated payments to be made in less than 24 hours for standard, non-fraudulent claims.
Our fraud detection system identifies claims that are atypical and/or have a high probability of being fraudulent. It recognizes these instances by utilising advanced statistical learnings combined with business rules, including system references to known fraudulent cases as a probability indicat-or.
Potentially fraudulent claims are highlighted for personal investigation by your experts. Standard, non-fraudulent claims are processed automatically. This enables faster processing and so higher customer satisfaction. With our on-line claims handling process, your customers can have their claims processed and payments made in less than a day.
The learnings element of our fraud model improves the accuracy of fraud detection. By reducing the time spent by your claims experts on non-fraudulent cases and highlighting possible fraud instances, our solution improves the efficiency of your claims handling operation.
In one example where we worked with a Nordic insurance company, our solution more than doubled fraud detection compared with best-in-class rules technology based on scoring solutions. At the same time, our solution enabled automated payments for non-fraudulent claims to be made within 24 hours and cut manual case loads by half.