How do you detect fraud while processing claims quickly?
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.
Fight claims fraud with predictive analytics
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.
Fast, accurate fraud detection
Machine learning and predictive models provide accurate claim scores and reason codes for swift triage, evaluation, or settlement decisions.
The world’s largest P&C claims database
Claim Scoring leverages data from over 1.8 billion claims industry-wide to identify fraudulent claims, surpassing models based solely on your own data.
Respond quickly to emerging risks
Build custom fraud scenarios to test ideas using expert business rules and other data points to create more efficient, flexible fraud detection.
Claims fraud detection that stays ahead of fast-evolving schemes
Discover how Claim Scoring uses machine learning, vast data sets, and predictive models to confidently expedite fraud detection and claim triage.
Claims fraud detection that stays ahead of fast-evolving schemes
Visual insights to improve claims investigations
Dashboards show you:
- Scored claims in real time
- Deep insights into reason codes used in claim scoring
- Questionable claim exposures in your geographical book of business
- Insights into loss history dynamics via ClaimSearch®
Features and capabilities
Claims predictive analytics through AI and machine learning
Claim Scoring uses multiple variables to identify claims for further investigation and uses fraud scenarios to give SIU meaningful context for model output.
Custom fraud rules for efficient claims fraud detection
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.
Access to more than 1.7 billion claims records
Claim Scoring compares claims to records in the world’s largest P&C claims database and leverages third-party data and civil/criminal records.
Related resources
Uncover ways to enhance your ability to detect insurance fraud swiftly and accurately, improving your fraud-fighting capabilities.
Resource center
Stay informed on the latest innovations
Discover the latest features and enhancements to our Claims solutions including ClaimSearch®, Digital Media Forensics, Claim Scoring and more to seamlessly adapt to updates and maximize efficiency.
White paper
Illuminate unseen claims fraud with advanced analytics
Brochure
The critical role fraud scenarios play in advanced analytics
Are you getting the right results from your fraud analytics? Learn how fraud scenarios enhance your investigations and improve model output.
Article
5 questions to ask before building a claims fraud analytics system
Do more with the Verisk ecosystem
Claim Scoring is part of a full suite of solutions that provide compliance, claims development, and deeper fraud analysis tools.
The world’s largest P&C claims database
Fast-track claims while improving fraud detection with access to data from more than 1.8 billion claims.
Fraudulent images in claims identified
This automated process applies a series of algorithms to every customer-submitted loss photo to expose anomalies.
Advanced link analysis to fight organized insurance fraud
Discover the hidden relationships and connections among claimants, providers, and businesses.
Missing details to complete claims
Get hundreds of supplemental data reports to enhance claim analysis and investigations.
Medical provider scoring
Advanced analytics and expert clinical oversight to detect medical provider fraud, waste, and abuse.
Contact us to learn more
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1-800-888-4476
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International Access code, then 800 48977489
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