Envisioning a Claims Fraud Detection App

By Carlos Martins  |  January 14, 2013

The mobile revolution is under way. While we’re still in the early stages of smartphone use in general, it’s clear that technology is already beginning to change how we live — and work. For claims adjusters, the revolution started years ago with laptop estimating and access to e-mail outside the office. But the future holds far more potential. When apps for the mobile claims adjuster and SIU eventually come to market, they could drastically improve the data that comes from the field and the time needed to collect it. In the end, claims departments will gain the benefit of richer information — and more of it — to use in making better claims-handling decisions.

To succeed, a mobile field adjuster/SIU app will need to enhance the overall claims-handling process. That starts with offering the tools to collect more information relevant to a claim sooner, mitigating the risk of forgetting necessary follow-up questions. An adjuster checklist for a liability claim, for example, could not only help capture the right information but could also serve as a prompt for additional questions based on a claimant’s answers — all in real time. Photo capabilities would help carriers capture pictures of VINs, license plates, and mailbox addresses, which the system could then convert through optical character recognition (OCR) into readable text for claims record augmentation and further analytics in ISO ClaimSearch®.

In general, mobile apps could reduce the need for cumbersome data entry along with the errors that tend to occur. Speed and accuracy would increase, and the collection of more data would offer more possibilities for analysis. Further, this would increase the quantity and improve the quality of data that adjusters and investigators collect. The mobile revolution, it seems, is poised to deliver tangible value to claims departments.

Of course, much work remains, especially given the rapid evolution of smartphone technology. Before diving in and developing apps simply because the technology is available, prudent service providers and claims departments evaluate through their business needs to create tools that users on the go will adopt and find helpful.

Carlos Martins

Carlos Martins, SCLA is Vice President and General Manager of ISO ClaimSearch Solutions. Carlos leads the operations of ISO ClaimSearch®, the property/casualty industry’s premier and only “all claims” database with over 1.2 billion claim records and market participation of more than 90 percent of the property/casualty insurance industry. Carlos is also responsible for the surrounding ecosystem of integrated solutions for ISO ClaimSearch which includes claim scoring, predictive analytics, third-party data, and visualization tools. Carlos brings to this role – and all ISO ClaimSearch participants – more than 30 years of experience in the property/casualty industry, where he has held a wide range of claims and technology roles. He is based in Jersey City, New Jersey and can be reached via email cmartins@iso.com or 201-469-3103.