Claims Fraud
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.
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…
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…
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…
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…
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.
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,…