FRAUD DETECTION IN INSURANCE CLAIMS

Insurance companies have to spend significant amounts of time and manpower to detect which claims are fraudulent. In addition, this is not a fool-proof process, which means that sometimes they end up paying claims that turn out to be false. Thirdly, during the process of investigation of claims, they often turn up against false positives, that is, dig deep into claims that are genuine. This creates a negative customer experience, that might even lead to some loss of business. We use Artificial Intelligence and Machine Learning to help companies use a smart approach to fraud detection. Firstly, our systems group the claims based on similar characteristics. Next, due to our intelligent algorithm learning from past fraud cases, as well as checking data from multiple sources, we are able to identify potential false claims with higher accuracy than manual checking processes. Thirdly, since the entire process is computerized, time of processing is reduced compared to manual process execution time. Finally, due to system accuracy, false positive cases are much reduced in number, thereby reducing negative client impression.