Improved Accuracy in Fraud Detection using AI
Catch more fraudulent claims, reduce false positives, improve quality of referrals, enhance siu productivity, improve customer experience
With the cost of insurance fraud estimated at $80 BN per year globally, industry players are facing substantial fraud losses today. There is a growing need for the ability to detect fraud accurately, leverage data across systems, improve customer experience through lower false positives as well as make investigations more efficient.
BRIDGEi2i’s AI powered Claims Fraud Management™ solution leverages advanced AI and hitherto untapped data to enable insurers dramatically improve detection rate of fraud. Insurers are able to capture a wide spectrum of Fraud patterns – new emerging fraud behavior and collusive relationships – real time, with greater speed and unprecedented accuracy.
Key Components
Holistic View of Claims
AI Engine combines all information available on claims, including non-traditional data such as agent notes, images as well as entity relationships
Multiple ML techniques
Uses combination of machine learning techniques to capture more Fraud cases (and types) and with greater accuracy
Forensic Investigator
AI enabled analysis of complex Fraud networks and all related relationships that need to be investigated at network level
Use AI to detect Fraudulent claims you are not capturing today
Harness Non-Traditional Information
Harnesses all available information including unstructured data such as claim notes, forms and images to significantly improve accuracy of fraud detection
Detects New types of Fraud
Proactively catches Fraud perpetrated by those using new evolving tactics
Improves Investigator Efficiency
Uses graph network to detect fraudulent nexus between entities, and identifies most suspicious relationships for investigation
Integrable and Configurable
Solution embeds in any claims workflow/ core system. Enables analyst interaction – insight to fraud score, reason for alert, configuring ML model output & rules
Get up and running within 4 months
Leveraging 50% pre-built components enables faster implementation (4 months) and time to value (12 months to ROI)
The multi national insurer was able to significantly improve fraud capture rates and bring down false positives by deploying BRIDGEi2i’s WatchTowerTM based Claims Fraud Management Solution for lines of business across multiple geographies including the US, Canada, Australia, France, UK, Germany and Makaysia
Why partner with BRIDGEi2i?
Our obsession with “value to customer” and “time to value” has shaped our engagement philosophy and we partner with our clients to make the journey from Information to Insight to Impact easier, faster, and sustainable. We leverage our proven problem-solving frameworks, extensive domain expertise, data science capabilities and proprietary AI accelerators to help companies accelerate their transformation journeys and build digital enterprises of the future.