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

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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

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Multiple ML techniques

Uses combination of machine learning techniques to capture more Fraud cases (and types) and with greater accuracy

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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

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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

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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

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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)

BRIDGEi2i’s Claims Fraud Management™ solution helped a Global P&C Insurance major improve fraud capture rates on claims by ~30% and improve quality of referrals by ~20%

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.

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