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Future Directions in Claims Investigations

In the future, advanced analytics and ­pre­dictive modeling will become increasingly automated, with more sources of data providing select investigative information. Such evaluative tools will speed investigations, reduce false leads, and, most significantly, enable better visualization of connections among individuals, businesses, and properties linked to organized insurance fraud.

Similar tools will be available at the point of purchase to detect possible misrepresentation in the insurance application process and identify applicants most likely to submit suspicious claims in the future. Using predictive models in both claims analysis and at the point of sale, insurers can build an effective perimeter defense. New data sets have recently become available to investigators researching cases and to underwriters screening applicants: property data to identify foreclosure activity for claims analysis, license plate reader information showing vehicle location, more detailed weather reports, and services that scan the vast information available on social media.

In addition to the automation of analytics and new data sets, insurers will see shifts in how claims and investigations personnel access information. Property and auto adjusting data sources are already available through mobile devices. The same convenience will apply to claims history and fraud analytics data as it becomes accessible through smartphones and tablets.

Insurers will use streamlined data paths and integrated tools to detect fraud throughout the enterprise at every point in the policy life cycle. Harnessing the power of advanced analytics and predictive modeling, drawing upon new data sources, and including more information delivery systems for mobile devices will make it possible. And as the insurance industry and technology evolve, ISO ClaimSearch® will continue to grow and adapt to serve the more than 100,000 claims and SIU professionals who use the system.

Richard Della Rocca

Richard Della Rocca is president, Claims Solutions at Verisk. He oversees Verisk’s integrated suite of services that improve claims processing, valuation, and fraud detection worldwide. Those services include the property/casualty insurance industry’s all-claims database, leading claims compliance and analytics solutions, the industry’s trusted source of catastrophic insured property loss estimates, and leading property claims estimating solutions.

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