Reducing the loss ratio by effectively detecting insurance fraud

Insurance fraud is a serious issue for the entire insurance sector. Payment of fraudulent claims has a negative effect on the loss ratio and on insurance premiums, which results into a competitive disadvantage. Moreover, investigating 'false positives' takes a huge amount of time and unnecessary costs. Fraudsters are getting smarter in their attempts to evade the insurer's radar. As a consequence, money flows to the wrong people and thus combined ratios are under pressure. Insurance companies must detect insurance fraud before claims are paid. The best way to reduce the loss ratio is to increase the chances of fraud detection at claims and limit false positives to a minimum.

Automated fraud detection


Fighting fraud is a manual operation within many organizations. Thus, fighting fraud can be a time consuming and error prone process. Organizations with an automated solution are more effective at fraud investigation by working and sharing cases at one place with all related information available. Chances of detecting fraud and limit false positives to a minimum could be higher when detection methods are automated.

Using automated fraud detection during the claims process enables an accurate estimation of the risks related to a claim. It improves straight through processing (STP), and claims that need further attention will be recognized directly. Such accurate and objective risk evaluations should be supported by various aids such as expert rules, risk profiles, predictive models, text mining and link analysis. The available information form external data sources could be essential and combined with internal data very valuable in the fight against fraud.

Honest insurance

Jeroen Morrenhof (CEO at FRISS) says: ''At FRISS, we believe in honest insurance. Our question for insurance companies: why do your sincere customers have to bear for the risk brought in by others? In the end it is the society that suffers from fraud. Our mission is to strive for a trustworthy insurance industry, healthy insurance portfolios and fair insurance premiums for everyone''.

Ready-to-use business solutions

FRISS has 100% focus and dedication to fraud detection and risk mitigation for non-life insurance companies worldwide. The FRISS solutions help insurers to improve their combined ratio in order to achieve profitable portfolio growth and enhance the perception in the market as a trustworthy insurer.

Due to the experience with 100+ implementations at insurers, FRISS solutions can go live in 8 weeks and have a ROI within 12 months on average. Customer specific configuration has the focus. In contrast with general purpose analytic software or homegrown systems that have to be built from scratch, FRISS is largely prebuilt and therefore a ready-to-use business solution.

Learn more about Fraud Detection at Claims


Related articles

TOP EVENT

See all