Misrepresentations and non-disclosure in life insurance applications are not just a problem for underwriting and pricing a policy accurately. They also present a major risk for claims. But identifying inaccuracies during underwriting and fraudulent claims can be a significant challenge.

80 percent

of life insurers experienced claims fraud in 2017, according to one study

 

How do you flag potential misrepresentations at point of sale and identify fraud at point of claim?

Accelerate and refine critical decision-making with robust data and analytics

Leveraging robust data and advanced analytics, Verisk is developing solutions to help life insurers make critical underwriting and claims decisions with increased speed and precision.

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Explore Verisk’s life insurance underwriting solutions

Our Tobacco Usage Propensity Model employs predictive analytics on emerging data assets such as lifestyle data as well as voice analysis of telephone interviews to flag potential tobacco users with a high degree of accuracy.

  • Accelerate underwriting for the vast majority of applicants who aren’t flagged as potential tobacco users.
  • Help reduce the need for invasive medical tests for the majority of applicants.

Learn more

 

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Our Avocation Model leverages licensing and marketing data to help you identify individuals who participate in extreme sports or high-risk hobbies that impact life expectancy.

  • Accelerate underwriting for the majority of applicants who don’t engage in high risk hobbies.
  • Quickly identify an applicant’s potential engagement in high-risk hobbies and the associated mortality risk.

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Our Driving History Solutions give you quick and easy access to driving records for use in your underwriting process.

  • Speed up underwriting by reducing the time needed to research violations.
  • Get records from any state in a uniform, easy-to-read format—complete with translations of violation codes.
  • Make faster, more informed underwriting decisions.

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Explore Verisk’s life insurance claims solutions

Our ISO ClaimSearch database uses advanced claims-matching technology to uncover fraud and improve efficiency for life insurance, disability and long term care claims.

  • Detect point-of-sale misrepresentation at the point of claim.
  • Identify activity inconsistent with disability for waiver of premium claims
  • Find missing beneficiaries.
  • Identify claims previously unknown to the Disability carrier, in which the Disability carrier is entitled to a financial offset or recovery.
  • Identify claims to expedite, vs those with historic patterns of fraud, waste and abuse, which may warrant additional investigation.
  • Apply matching claim algorithms to insureds, but also to guardians, powers of attorney, and caregivers, in a HIPAA compliant manner.
  • Efficiently comply with regulations prior to payment through e-matching for OFAC, and child support enforcement.

With access to this broad dataset of over 1.5B claims records, and 250K claims records received each day, life, disability and LTC insurers can access insured and beneficiary matching algorithms to get a more holistic view of their claims.

Learn more

 

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