ClaimSearch® is more than the world’s largest database of property/casualty claims—it’s also a robust claims intelligence platform. Its claims-matching technology is an essential first step in fraud detection, and the results can help facilitate fast-tracking. The platform also provides seamless access to integrated claims fraud-detection and investigative analysis tools.
More than 95% of the property/casualty insurance industry relies on ClaimSearch.
When an adjuster enters a claim into ClaimSearch, it's compared to more than 1 billion claims. If there's a match, the adjuster gets an alert with details. This match report is a vital first check against claims fraud because it can turn up:
Historically, 86% of claims entered into ClaimSearch have returned matches.
Determine if claims can be fast-tracked or if they require a closer look with at-a-glance insight.
Each claim is color-coded (next to the claim number in the upper left-hand corner) to reflect whether it has the following:
The dashboard includes a list of specific alerts (if applicable) as well as a timeline of any matching claims with loss type. You can drill down to learn more about both alerts and matches.
If claim status is green, consider fast-tracking. Yellow claims with matches may need a quick review—or more, depending on the matching claims found. Red claims with alerts may need to be slowed down for evaluation and possibly referred to SIU.
Life insurers can use the advanced claims-matching technology of ClaimSearch to help:
ClaimSearch serves thousands of insurers, all 27 workers’ compensation insurance funds, more than 400 self-insureds, numerous third-party administrators (TPAs), and many state fraud bureaus and law enforcement agencies involved in insurance fraud investigation and prosecution.
When it comes to processing claims efficiently, every second counts. That's why we've developed our cutting-edge Claims and Policy Report, designed to fill in data gaps as early as the First Notice of Loss (FNOL).
Find critical data to complete claims quicker, spot potential fraud, and fill in gaps to improve decision-making.Learn more
Uncover medical provider fraud, waste, and abuse in your medical billing data with predictive analytics and expert clinical analysis.Learn more
Fight claims fraud with the power of predictive analytics and leverage accurate claim scores to expedite meritorious claims for settlement.Learn more
Identify organized insurance fraud activity in your claims with network analytics built on robust industry data.Learn more
Uncover fraud and preexisting damage in customer-submitted and third-party loss photos with the new digital media database and image forensics in ClaimSearch.Learn more
ClaimSearch customers can detect preexisting damage and uncover potential image fraud with the digital media database. This free enhancement gives you access to prior-loss photos on match reports and cutting-edge image forensics to detect suspicious images.
ClaimAlert™: Foreclosure reports foreclosure activity users report to ClaimSearch. It alerts you when a claimant has a property in foreclosure, giving you an opportunity to investigate cases where moral hazard could be an issue.
ClaimSearch customers can access all the functionality of the visualized claim intelligence platform in Guidewire ClaimCenter. The ClaimSearch accelerator allows users to access claim history insights without leaving their claims management system.
Now claims representatives can truly collaborate with policyholders. Involving the policyholder more deeply in the claims process can help improve customer satisfaction and reduce claims-handling costs.
Respond® predictive analytics help you correlate each storm’s severity and anticipate the storm's effects more accurately. You can better mitigate risk, improve service, and optimize response resources.
With Respond, Verisk is changing the way insurers react to damage from natural hazards. Respond lets you visualize the effect of each peril in the context of local policies. The near real-time weather analytics are tailored to your needs and integrated into your workflow.
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