Fraud Detection at Claims

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Use AI powered fraud detection during the claims process to make an accurate estimation of the risks related to a claim. Automatically detect insurance fraud before claims are paid. Reduce your loss ratio by increasing the chances of fraud detection at claims and limit false positives to a minimum. The solution enables fast track claims, straight through processing (STP) and enhances customer satisfaction.

Key Features

AI Powered Intelligent Detection

Automated Fraud Scoring

Actionable Insights

Integrated Case Management

Key Benefits

As a proven standard, the FRISS Score is the core of the solutions and indicates the risk for each claim. It provides a white box, holistic view on fraud and risks, delivering actionable insights. The FRISS Score is based on a hybrid detection method. It combines insurance expert business knowledge, out of 10+ years of experience, with external data sources and AI.

The detection system provides an accurate estimation of the fraud and risks with the aid of expert rules, profiles, predictive models, text mining and link analysis together with all available information in more than 100 external data sources. Based on this estimation, a risk score is given (FRISS Score). The higher the score, the higher the potential risk of fraud.


Case Studies