Many claims departments lack the IT resources and broad industry data needed to develop effective fraud analytics systems. But implementing third-party analytics can be expensive and time-consuming. Plus, fraud models can have confusing outputs, wasting SIU time.
Claim Scoring™ lets you score and evaluate claims quickly and effectively using your own real-time data plus aggregated data from 95% of P&C industry carriers.
Machine learning and predictive models provide accurate claim scores and reason codes for swift triage, evaluation, or settlement decisions.
Claim Scoring leverages data from over 1.8 billion claims industry-wide to identify fraudulent claims, surpassing models based solely on your own data.
Build custom fraud scenarios to test ideas using expert business rules and other data points to create more efficient, flexible fraud detection.
Discover how Claim Scoring uses machine learning, vast data sets, and predictive models to confidently expedite fraud detection and claim triage.
Dashboards show you:
Claim Scoring uses multiple variables to identify claims for further investigation and uses fraud scenarios to give SIU meaningful context for model output.
The sandbox environment in Claim Scoring lets you create and test custom rules, create targeted alerts for your modeling, and collaborate internally with data scientists to optimize scoring.
Claim Scoring compares claims to records in the world’s largest P&C claims database and leverages third-party data and civil/criminal records.
Claim Scoring is part of a full suite of solutions that provide compliance, claims development, and deeper fraud analysis tools.
Fast-track claims while improving fraud detection with access to data from more than 1.8 billion claims.
This automated process applies a series of algorithms to every customer-submitted loss photo to expose anomalies.
Discover the hidden relationships and connections among claimants, providers, and businesses.
Get hundreds of supplemental data reports to enhance claim analysis and investigations.
Advanced analytics and expert clinical oversight to detect medical provider fraud, waste, and abuse.