Insurers are turning to AI to detect claims fraud automatically – but to get the most from their analytics, they need to understand an anti-fraud system.
Taking a closer look at medical billing helps identify pandemic-related issues that can put patients at risk and negatively impact insurers’ bottom lines.
Neural networks, machine learning, multivariate random forest models, and various derivatives of the same are being used to create modern fraud detection models.
Unfortunately, crisis is fertile ground for fraud, whether it be the opportunistic kind or organized criminal activity.
Claims adjusters are now working at home, relying on customer-submitted images and videos to inspect and appraise damages for the foreseeable future.
As the industry (and nation) continue to deal with the challenges of the current health crisis,we want to provide you with some resources which you may find helpful.
As we enter 2020, the insurance industry looks much different than it did ten years ago.
As claims fraud persists—costing insurers approximately $30 billion a year—adjusters play an important role in identifying questionable claims early.
For insurers looking to stem the $30 billion-a-year insurance claims fraud problem, early detection is key.
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.
Insurers in Ireland need to look at how they can use data from a wide variety of sources to significantly reduce the risk of fraud at the application and claims stage.
It’s no secret that medical fraud is a big problem, with some sources estimating the cost at more than $200 billion annually.
Complex medical bills can make it difficult for adjusters—already overloaded with cases—to find potential fraudulent or excessive billing.
Life insurers can face a myriad of challenges today. Some of those issues have plagued the industry for years—such as stagnant premium growth and low interest rates—while…
NYCM has implemented Verisk’s newly enhanced ClaimDirectorSM and NetMap for ISO ClaimSearch® solutions to assist in accurate and early detection of insurance fraud.
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