Better fraud detection capabilities could help shave five percent off insurers’ claims costs. However, as I mentioned in last week’s blog post, despite the benefits, insurers have been slow to implement detection initiatives.

Accenture finds that insurers can generate savings through a combined fraud detection approach that:

  • Provides better service levels and more efficient claims processing to generate customer satisfaction, helping increase customer loyalty and deterring individual episodes of fraud.
  • Uses advanced analytics tools for greater focus in detecting fraud.

Proven strategies for addressing fraud in insurance

How to Effectively Fight Insurance Fraud
View the PDF.

Four strategies can help insurers address fraud, from individual incidents to complex, organized fraud:

  • Using business rules to detect irregularities. Rules can compare claims based on various types of fraud and determine whether to investigate the fraudulent incidents, and when.
  • Employing predictive modeling. Predictive analytics can detect potential fraud earlier in the claims process, thus reducing payments made to fraudsters.
  • Undertaking network analysis. New technology solutions can help identify the extent of the relationships between the investigated parties, and the information and insights gleaned can be used to define indicators that point to fraudulent activity.
  • Closing the loop and intervening. When a risk is identified, immediate action can be taken, including investigation by a team of specialists, and interaction with the claims management unit and the insured.

Next week I’ll take a closer look at the role of analytics in helping to combat fraud in the insurance industry.

In the meantime, to learn more, download: How to effectively fight insurance fraud.

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