Insurance
A recent RGA survey suggests that the global incidence of claims fraud is 3.58%.
The Challenge
When insurers detect a potential fraudulent claim, they must follow a process to determine the validity of the fraud. This can involve outsourcing the investigation to a third-party factual investigator. Handover of the case and the subsequent updates and decisions on the investigation need to be timely and accurate.
The Solution
The Insight Portal™ provides both the insurers and investigators transparency and timely updates within investigations. A single common interface for both users provides a fused view of the updates and next steps in an investigation to allow an insurer to pay or deny the claim.
The Applications
Case Management - Timely dissemination of potential fraud for investigation to outsourced investigators.
Policyholder Background Check (KYC) - Consolidated view of all prior claims and parties to a claim. A single window on all data relating to a policy underwriting decision.
Supplier Fraud Detection - Search and link across multiple investigations and claims to find anomalies in supplier costs and associations with claimants.