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Anti-Fraud Claims Solutions

Get equipped to fight claims fraud

Rising fraud, mounting costs

Claims fraud isn’t new for property/casualty insurers, but the game has changed. Digital processes are speeding claim settlements but increasing fraud exposure. And, as claim frequency and costs rise, so does fraud leakage.

Insurers struggle to keep pace

Lack of IT resources, long development processes, and insufficient data make building effective fraud analytics difficult. Meanwhile, SIUs struggle to get meaningful insights to guide investigations.

10 percent of claims are fraudulent. Ready to stop the leakage?

Robust data fuels powerful fraud analytics

Unmatched industry data and leading analytics are the core of Verisk’s comprehensive suite of anti-fraud solutions. It’s why we’re uniquely equipped to empower SIU to fight claims fraud with greater speed, precision, and efficiency.

1000 Plus Rules
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Discover the fraud detection solution Celent calls “Luminaries”

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Discover the fraud detection solution Celent calls “Luminaries”

Celent’s Insurance Fraud Detection Solutions: Property and Casualty Insurance report connects insurers with innovative tools that excel in advanced technology and breadth of functionality. See why Verisk is a 2022 Celent “Luminary” in the property/casualty market.

Uncover medical provider fraud early

Provider Fraud

Uncover medical provider fraud early

Medical billing data is complex. That’s why it’s the perfect place for unscrupulous providers to hide fraud, waste, and abuse. Our provider fraud solution uses predictive analytics and expert clinical analysis to identify fraud in your medical billing data.

  • Get weekly risk scores for over 1.5 million medical providers
  • Improve investigations with detailed reason codes
  • Lower allocated loss adjustment expenses (ALAE)
Predictive Mini Models

Enhance your analytics with AI powered models

Want better results from your fraud analytics? Boost your organization’s models with out of-the-box, predictive mini-models developed from the industry’s most comprehensive loss history database.

  • Realize a 3X ROI lift
  • Implement mini-models in less than a day
Learn more about predictive modelling

Detect claims fraud with the power of predictive analytics

Automated fraud analysis at FNOL not only identifies questionable claims early—it also helps expedite legitimate losses. Leveraging machine learning predictive models and 1.6 billion claim records, ClaimDirector accurately scores all incoming claims and provides reason codes to enhance investigations.

  • Improve triage and get actionable insights for investigators.
  • Operationalize the solution in less than a week with no IT lift.
  • Leverage third-party data sets and criminal and civil records.
Learn more about claims fraud analytics

Get the latest anti-fraud insights

Fraud Sign Teaser

Who commits insurance fraud What motivates insurance fraud?

Part two of Verisk's study delved deep into public perceptions and attitudes toward what motivates them to commit insurance fraud.

Read the article
Fraud Sign Teaser

Who commits insurance fraud is insurance fraud a crime?

A study Verisk conducted delved deep into public perceptions and attitudes toward insurance fraud. The results shed light on certain beliefs

Read the article
Fire Teaser

Fraud Fighting with Predictive Analytics & Modeling

Uncover why using AI-driven predictive models and advanced analytics in a hybrid approach can help you easily identify fraud

Read the article
Undetected Fraud Teaser

Uncover the Undetected Fraud in Your Claim

Annually, insurance fraud steals roughly $308.6B from American consumers. Self-insureds could be vulnerable to insurance fraud and undetected leakage.

Read the article

Discover organized fraud activity in your claims

Organized Fraud

Discover organized fraud activity in your claims

Sometimes a simple claim can be part of a larger fraud scheme. Our network analysis software helps you uncover hidden connections among claimants, providers, and businesses by analyzing 1.5 billion claims, plus vetted third-party data.

  • Identify intricate patterns of organized fraud in your claims
  • Save SIU analysts time with automated data link analysis
  • Get customized weekly reports of suspicious networks

Verisk's premier solution for fraud bureaus

State Fraud Bureau Challenges

Verisk's premier solution for fraud bureaus

Anti-Fraud One – Government (AF1-Gov) leverages a combination of the solution sets already utilized by most property and casualty carriers, TPA, and self-insureds.

Implementing a tailored and agile fraud referral scoring system, AF1-Gov, fits the needs of state fraud bureaus and prosecutors.

Contact Us to Learn More

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