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  5. Insurance Fraud Mitigation Technology: Beyond Red Flags

Insurance Fraud Mitigation Technology: Beyond Red Flags

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18 March 2007
Donald Light

Abstract

San Francisco, CA, USA March 19, 2007

Celent looks at how technology is giving insurers new tools to fight fraud.

In a new report, , Celent identifies the fraud mitigation strategies available to insurers, and the specific technology solutions that can make those strategies much more effective than the traditional red flags.

The report estimates the amount of addressable fraud, that insurers can actually find and fight. It describes the business value of fraud mitigation technology, and provides examples of leading vendors and solutions. It also identifies fraud mitigation best practices.

Source: Celent analysis

"Celent estimates that the amount of fraud that is actually addressable ranges from 1% to 4% of claims or expenses in the different sectors of the insurance industry," said Donald Light, senior analyst and author of the report.

Light continued, "Fraud identification technology ranges from very simple to very sophisticated. Available technology and tools include: red flags, predictive modeling, neural networks, profiling, claims databases, identity matching, link analysis, and investigation management. A good fraud mitigation program will combine several technologies and methods, using vendor-supplied tools and working with vendor professional services groups."

The 25-page report contains four figures and three tables. A table of contents is available online.

Members of Celent's Property/Casualty Insurance and Life/Health Insurance research services can download the report electronically by clicking on the icon to the left. Non-members should contact info@celent.com for more information.
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