The Essential Importance of Insurance Fraud Claim Detection Software

| July 14 2017

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Before we get into insurance claim fraud detection software and why it’s so essential for your business, let’s take a quick detour by way of an amazing statistic.

At its market cap peak, General Motors employed over 800,000 people. When Google reached that same market cap, how many people do you think it employed? (Cue Jeopardy music.) The answer is 58,000 people.

We all know that it takes less staff to run a digital business (think about the term “lean startup”) and the overall landscape is one of automation. A word similar in construction to automation? Automatic.

This is where any discussion of insurance claim fraud detection software needs to begin.

The advantages of insurance claim fraud detection software

Business is busier these days than ever. Globalization and digital/mobile opened up so many more partners and opportunities, but that also means more to do -- and, yes, more boxes to check.

One of the major boxes from a legal/compliance standpoint is checking on insurance claims. In recent years, the legal ability to do this across social media has grown. If a user posts something, even with a reasonable expectation of privacy on their end, it can still be used in social media capture/discovery.

At the three-way intersection of “We are all so busy” and “Insurance claims are an aspect of that” and “The legal climate surrounding social media capture,” this is what you need:

  • Some type of insurance claim fraud detection software that …
  • … ideally can scrape websites and social media …
  • … intelligently identifies the claimant’s profile within an identified degree of certainty...
  • … and it’s all done automatically

A simple use case

Let’s say your insurance organization receives a claim that sets off some red flags. Something is suspicious, so your claims manager refers the case to SIU. Now it’s time to kick off the social media investigation. But, what now? We all know how costly and time consuming it can be to find the John Smith on Facebook.

What now?

We offer solutions in both social media discovery (across rich formats, too) and compliance. If you have questions about how it all works, how we use AI to find relevant profiles, how we crawl data, or how it becomes an automatic process that you don’t even need to think about, let us know and we’d be glad to help you navigate the space.

Insurance claim fraud detection software will be good for your bottom line, too -- and while you don’t have to lay off the number of people between GM’s peak and Google’s peak, you can put your existing people onto more productive projects. The automatic software handles the social investigation part.

To find out more about how your insurance company can incorporate AI into its processes, download our latest whitepaper: AI Could Be Your Next Claims Investigator.

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Hanzo’s purpose-built, best-in-class solutions can help your readiness to respond to the next discovery request, investigation, or audit. Contact us to learn more.

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