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Shift Claims Fraud Detection

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Overview

Shift Claims Fraud Detection is a best-in-class, AI fraud-fighting solution for P&C insurers. Able to detect claims fraud in real time or in scheduled workflows, this solution can deliver 3X the detection hit rate compared to manual or rules-based implementations. Furthermore, Shift Claims Fraud Detection delivers transparent findings to users with detailed rationale for all of its conclusions. This allows investigators to make fraud decisions with speed, accuracy and confidence.

Key Features

  • Finds previously undetectable fraud with AI analysis of all structured & unstructured claims data backed by the world's largest team of insurance-focused Data Scientists
  • Reduces false positives to drive more efficient workflows
  • Identifies simple cases of individual fraud and more sophisticated network fraud schemes
  • Clear contextual guidance and supporting documentation to speed investigations
  • Seamless API integration with insurer core systems
  • SaaS-based solution; 4 months to full integration and accelerated ROI

Key Benefits

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 – Shift Claims Fruad Detection 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