FORCE

Founded in 2014, Shift Technology provides insurance companies with an innovative SaaS (Software as a Service) solution that leverages artificial intelligence and sectoral expertise to improve and scale fraud detection. The solution, called Force™, provides a decision-making platform specifically designed for insurance fraud handlers to augment their capacity to detect a wide spectrum of fraudulent behaviours, from opportunistic claim exaggerations to organized crime rings. The idea is not to replace the human fraud handler, but replicate his or her deductive reasoning and apply it at large scale. The insurer simply sends Shift their claims data and Force™ takes care of the rest: analyzing the claims, retrieving and cross referencing relevant information from both internal and external databases, and sending scored alerts in real-time. The solution, which can be rapidly implemented in as little as four months, is designed to seamlessly integrate with an insurer’s existing operational processes, regardless of the technical context.

Once partnered with Shift Technology, the insurer collaborates with their dedicated Data Scientist team in a series of workshops that provide the framework the insurer’s specific fraud environment. After establishing the those needs, the Data Scientist will work behind the scenes to tailor algorithms designed to reproduce the fraud handler’s deductive reasoning. These algorithms will be tested and further fine-tuned in a implementation phase during which our solution, aggregates, de-noises, encrypts, and analyzes a set of the insurer’s historical claims data. The final results are then used to create a business case that will determine the insurer’s willingness to move into a “run” phase consisting of continuous analysis of real-time data and claims. Once in production, the insurer’s fraud handlers log into their personalized dashboard, configured to highlight the most suspicious claims discovered by our tool.

Why we’re better:

While other fraud analytics also offer rudimentary claims scoring, Shift Technology goes beyond simply providing probability of risk; we also furnish clear, actionable insights on which indicators make the claim suspect. Furthermore, depending on the circumstances surrounding the claim, our context sensitive model can intelligently increase (or decrease) the weight of suspicious indicators, and most impressively, provides a framework to detect fraudulent networks.

Globally, our tool boasts a 75% hit rate on all alerts we send to our customers, compared to an industry best of 35% among our competitors. In addition to more precision and fewer false positives, our customers enjoy the following:

• Increased productivity among fraud handlers - letting them focus on the claims that matter

• Low impact on the existing processes and activities – Force™ adapts to fit into the insurer’s organizational structure

• Quick adoption – ergonomic and customizable dashboard

• Tangible short-term ROI - savings from increased detection rates can outweigh the implementation costs within weeks