Insurers know the reality of claims fraud. It is increasing, it is becoming more sophisticated and it is a costly drain on profitability. Recent Insurance Council of Australia estimates put losses as high as $1 billion per year.
Is it a battle worth fighting? YES.
Is it a battle you can win? YES.
The NetMap Analytics competitive advantage:
For many years now, leading US insurers service providers ISO, Verisk has consistently utilised NetMap Analytics base technology to develop very sophisticated software to effectively combat insurance claims fraud and offer risk assessment services and decision analytics for professionals in many fields of insurance, including:
Dramatic savings and improve profitability have been the result particularly in the motor vehicle claims area. NetMap Analytics can now provide all Australian insurers with the opportunity to secure this significant competitive advantage. In the past, it was considered reasonable to offset high claims costs with premium increases and not worry too much about tracking down and monitoring of every non-compliant claim. Those days are gone with competition on the rise in every sector of the insurance industry. We need to monitor all claims daily to stay ahead.
NetMap Analytics has launched DetectR for Claims, “a complete cloud-based loss prevention solution” for use in the fight against insurance fraud. Using this product, investigators can interrogate and visualise multiple data sets, without having to understand the underlying location or construct of the data being used. Built-in high-level exceptions called “Transactions of Interest” (TOI) assist exploration. Intuition combined with knowledge of the industry can be effectively put to work discovering all breaches of “claim legitimacy and verification procedures”. The need for further in-depth investigation can be established with all the required data made available to the investor within the application. DetectR can recall previously discovered fraud schemes for reuse to eliminate duplication of work. All of this functionality is provided without the need to compose any complex queries for database query code.
The initial entry point for your investigation is a high-level query called a ToI which provides a structure for display and analysis of selected entities that are commonplace within the data source.
This may produce many results, by using our intuition we select one for further investigation.
Let’s look at all claimants using that doctor.
View the original policy document. It all there at your fingertips.
The NetMap Analytics DetectR fraud prevention software system is a visual interface for data from various sources that generates powerful graphics displays, interactive visual analysis and visual mining capabilities to enable efficient investigations and analysts to “see” information according to the criteria they are focused upon.
Those hidden connections are red flags to fraud investigators and once you see the connections you can earmark claims for further in-depth analysis.
In a matter of minutes, DetectR reveals connections, links and patterns in your data that could take you months of manual investigation to reveal, if ever. How? Instead of looking at single claims individually, NetMap Analytics performs a simultaneous, in-depth analysis of ALL your data. Custom-developed for the insurance industry, our powerful software tools draw on millions of items of data from claims, policies, payments and medical bills. Suspicious, previously invisible connections suddenly become very visible.
Fight fraudulent claims more aggressively than ever before. Rather than simply relying on tips, chance or obvious discrepancies, NetMap Analytics gives you a depth of knowledge that allows you to uncover complex fraud rings and elaborate schemes. It is time to match the fraudster’s sophistication with your own.
Save investigators hours of precious time by providing them with easy to use tools. NetMap Analytics owns state of the art technology to enable your investigators to deliver superior results faster, more effectively and at less cost. You will recover your missing revenue sooner!
Reducing fraud costs obviously increases your profitability. It can also allow you the opportunity to reduce your premiums and attract more customers in a highly competitive market. Either way, it is good news for your bottom line and your shareholders.
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