Success Story:

Insurance Fraud Detection & Investigation

Challenge:

The Insurance Firm has challenges in investigating and responding to fraud suspicions, at the same time, there is pressure on them to react to insurance claims in a timely manner to preserve their customer satisfaction. Fraud is not only multifaceted but also overlapping, Fraudsters are also constantly innovating and exploiting loopholes and vulnerabilities, especially with newer digital channels.

Solution

We implemented Insurance Fraud Detection Solution which easily integrates with their existing systems to strengthen their anti-fraud arsenal, accelerate the review of alerts, and wipe out false positives. The Solution Helps quickly observe the context around the claims, identify anomalies and suspicious activity immediately and take the investigation to the next level in just a few steps.

Business Result

  • Reduced claims triage overall time.
  • Investigate suspicious cases 10X faster.
  • Expose up to 20% more fraudulent activity.
  • In a single intuitive interface, get a 360° view of all information linked to a claim including internal data from different lines of business, public data, national databases of known fraudsters, etc.
  • Empower investigators to work smarter, foster collaboration and get the most out of your anti-fraud teams to streamline insurance fraud investigations.
  • Easily and quickly explore the full context around suspicious claims, identify hidden relationships, and quickly uncover patterns indicative of fraudulent activities.
  • Precisely identify even the most sophisticated insurance fraud schemes involving complex fraud techniques and organized fraud networks.

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