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Home > Solutions > Commercial Systems > Areas of Interest > Investigative Analysis > Insurance Claims Mgt
If dramatically increasing the accuracy and effectiveness of claims processing, reducing losses from fraud, and improving customer service are important to you, ASI can help. Our Claims Analyst’s Associate (CAA) solution proactively will enable claims analysts to weave together seemingly random, disparate pieces of data that are indicative of claims fraud. The CAA will increase analysts’ productivity and reduce losses by automatically detecting events and proactively alerting analysts to claims activities that might be fraudulent – in a fraction of the time previously possible!
Rapid Access to Powerful Capabilities
The Claims Analyst’s Associate will leverage ASI’s breakthrough Associate Systems technology, giving analysts access to key capabilities that can be difficult or impossible to achieve using other tools:
- Dynamic Analysis: Unlike statistical analysis and rules engines, CAA doesn’t stop once it gets initial results. Instead it will proactively seek additional information from widely distributed data sources and automatically continue to reassess cases still under investigation.
- Analyst Collaboration: The CAA will proactively collaborate with the claims analyst by providing a complete audit trail of the evidence it uncovers. This traceability will raise the skill level of a less experienced analyst to produce results close to those of a seasoned professional.
- Causal Modeling: CAA assesses, relates and integrates all relevant information – claims activity, behavior patterns, and relevant background information – as it becomes available. CAA can also integrate uncertainty directly into its analysis. In many cases, it will even be able to detect high risks of fraud BEFORE they can be carried out.
The Benefits Are Significant
- Improved fraud detection
- Faster investigations and response times
- Lower data retrieval costs
- Fewer false positives
- Remarkable gains in analyst productivity and consistency
- More consistent expertise
- Better visibility of probable cause
- Results you can have confidence in
- More valuable information
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