Detect claims fraud quickly and accurately with predictive analytics

Insurers need to determine quickly and efficiently whether a claim is likely to be fraudulent—or if it can be fast-tracked for settlement. ClaimDirectorSM uses the power of predictive analytics to score claims with greater accuracy and reveal questionable attributes.

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Operationalize fraud analytics in days, not months

  • Direct linkage to ISO ClaimSearch®
  • SaaS delivery with no IT lift
  • Standard implementation in less than a week

Improve claims triage with our AI-powered models

ClaimDirector combines predictive analytics and industry-based rules to analyze claims and identify fraud indicators within ISO ClaimSearch. It generates an accurate score to help adjusters decide whether to process a claim or triage it, along with reason codes to inform SIU teams about specific details that warrant investigation. The solution uses AI algorithms to determine the likelihood of claims fraud:

  • Compares claims to 1.3 billion records in ISO ClaimSearch plus NICB data
  • Evaluates claims by type, line of business, loss date, and loss type
  • Provides scores and reason codes for both claim and entity
  • Revises scores in real time as claims are updated
  • Customizes claim triage based on company preferences
  • Provides access to financial, criminal, and civil records

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Property/casualty insurance fraud costs insurers $34 billion a year

Does Your Claims Operation Look Like Easy Prey to Fraudsters?

SIU and business intelligence dashboards highlight fraud insights

ClaimDirector displays dynamic visual analysis of scored claims.

  • Investigators can review scored claims in real time and identify fraud characteristics faster using the SIU triage page.
  • The business intelligence dashboard provides deeper insights into the rules and data that calculate scores for claims.

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Leverage comprehensive and customizable rules

The ClaimDirector automated score is generated from predictive models and an extensive set of customizable rules, including:

  • More than 300 claim and involved-party rules
  • More than 1,000 rule combinations

For more Verisk claims fraud solutions, check out: