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.
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 1.5 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
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.