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

  • Native integration with 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 1.5 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

Property/casualty insurance fraud costs insurers $30 billion a year

Illuminate unseen claims fraud with advanced analytics

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 AI in fraud detection

Incorporating emerging tech such as AI, machine learning, and predictive analytics in fraud analytics requires four critical data components: variety, value, volume, and velocity.

For more Verisk claims fraud solutions, check out: