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Claims Fraud

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May 1, 2020

Medical-related fraud and theft increase during COVID-19 crisis

Unfortunately, crisis is fertile ground for fraud, whether it be the opportunistic kind or organized criminal activity.

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February 27, 2020

Five data-driven strategies for fighting insurance claims fraud

As we enter 2020, the insurance industry looks much different than it did ten years ago. Technological advancements, InsurTech innovations, and customer experience…

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January 27, 2020

Picture this: Get critical claim insights from vehicle location photos

As claims fraud persists—costing property/casualty insurers approximately $30 billion a year—adjusters play an increasingly important role in identifying questionable…

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January 16, 2020

How to find fraud in insurance claims

For insurers looking to stem the $30 billion-a-year insurance claims fraud problem, early detection is key. But with caseloads rising and hundreds of thousands of…

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December 20, 2019

Property/casualty medical fraud: 5 strategies for reducing your exposure

It seems like every month there’s news of another medical fraud bust, often involving rings of various types of providers. But that’s just the tip of the iceberg. There’s…

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December 10, 2019

Want to reduce cycle times? Find missing claim details faster

Claims adjusters are charged with a difficult task: They have to process claims quickly and efficiently, but sometimes they don’t have the necessary information to do so.…

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November 4, 2019

3 keys to stopping medical provider fraud, waste, and abuse

It’s no secret that medical fraud is a big problem, with some sources estimating the cost at more than $200 billion annually. But knowing the problem is one thing.…

Fraud
August 26, 2019

Getting serious about fighting medical provider fraud

Complex medical bills can make it difficult for adjusters—already overloaded with cases—to find potential fraudulent or excessive billing.

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March 8, 2019

NYCM Insurance implements Verisk’s ClaimDirector and NetMap fraud detection solutions

NYCM Insurance has implemented Verisk’s newly enhanced ClaimDirectorSM and NetMap for ISO ClaimSearch® solutions to assist in accurate and early detection of potential…

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October 16, 2018

Uncovering fraud in auto extended warranty insurance

For most drivers, purchasing an extended automotive warranty for their vehicle means peace of mind in the event their vehicle malfunctions and needs critical repairs. For…

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July 30, 2018

5 questions to ask before building a claims fraud analytics system

With the industry focus and media attention on data analytics in insurance, many SIU leaders are considering enhancing their team’s investigative capabilities with a…

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July 11, 2018

How a professional’s reputation can expose inflated claims

Trusting information at face value is a thing of the past. Claims professionals know this well, because they must gather information on a claimant and research prior…

Claims Blind Spots
April 25, 2018

Looking beyond the blind spots to get the whole claims picture

Missing details can be key to settling insurance claims. What insurers don’t know can definitely hurt them.

Verisk Medical Provider Fraud
September 21, 2017

Spotting the unseen menace: Medical provider fraud, waste, and abuse

Although the insurance industry is constantly plagued by suspicious claims activity, the unseen menace that’s leading to diminished profits is medical provider fraud,…