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Fraud Detection at Claims - Detect insurance fraud before claims are paid

AI Powered Fraud Detection

Use AI powered fraud detection at claims to make an accurate estimation of the risks related to a claim. Automatically detect insurance fraud before claims are paid. Reduce your loss ratio by increasing the chances of fraud detection at claims and limit false positives to a minimum. The solution uses an intelligent detection engine which raises automatic red flags, enables fast track claims and enhances customer satisfaction.


Product Sheet




Reduce Insurance Fraud

Insurance fraud is a serious issue for the entire insurance industry. Payment of fraudulent claims has a negative effect on the loss ratio and on insurance premiums. It 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. Fraud Detection at Claims helps you to solve these challenges and to reduce insurance fraud.

Fraud Detection Solution

Claims process

Intelligent Detection Engine

The robust intelligent detection engine uses multiple techniques. Techniques like automated business rules, text mining, image screening, device identification, fuzzy matching, geo-mapping, social network analysis and cross border searches deliver immediate actionable insights. By leveraging historical claims data the engine reveals previously unknown schemes. Implement self-learning models to predict fraudulent claims. Predictive analytics suggest next-best-actions to support claim adjusters and special investigators in their investigation in the fully integrated case management module.

Automated Fraud Detection

Detect insurance fraud before claims are paid. Catch more fraudsters. Use automated fraud detection during the claim process to make an objective and uniform estimation of the risks related to a claim. Receive automated red flags for suspicious claims. Uncover hidden relationships. Claims that need further attention or require active follow-up can be immediately investigated.

Explainable Artificial Intelligence

The AI powered fraud analytics translates into easily interpretable information (XAI), which is visualized into interactive apps. Social networks can be visualized. Fully automate your link detection to identify anomalies. Fight fraud by using AI and get immediate actionable insights in results. The whitebox approach provides a holistic view on suspicious claims. Turn your data into knowledge.

Expert Industry Knowledge Inside

Fraud Detection at Claims is stuffed with over 10 years of industry experience. The ready-to-use and flexible business solution combines analytics, AI and machine learning techniques with knowledge from 150+ implementations at insurers around the world. Expert knowledge is combined with machine learning techniques to enable a guided self-learning solution. You can leverage the FRISS industry experts to maintain the solution or do it yourself. Fraud Detection at Claims is live within 6 months and has an ROI within 12 months.

Integrated Fraud Case Management

Become more effective at fraud investigation by working and sharing cases at one place with all related information available. The follow-up and investigation of possible fraud cases is also supported through an integrated case management module. Moreover, FRISS supports the sharing of fraud incidents and claim history to prevent fraudsters moving around the industry.

Improve Customer Experience

Reduce the number of false positives and improve the customer experience. Because claims can be adjusted faster, the customer has a smooth experience from filing the claim to payout. The screening of a claim can have various touch points in certain stages of the claim process. Because of the real-time screenings this goes fast and efficient. Guiding the sincere customer through a happy customer journey.


FRISS Score

The FRISS Score is the core of Fraud Detection at Claims - Detect insurance fraud before claims are paidAs a proven standard, the FRISS Score is the core of the solutions and indicates the risk for each policy application or claim. It provides a white box, holistic view on fraud and risks, delivering actionable insights. The FRISS Score is based on a hybrid detection method. It combines insurance expert business knowledge, out of 10+ years of experience, with external data sources and AI.

The detection system provides an accurate estimation of the fraud and risks with the aid of expert rules, profiles, predictive models, text mining and link analysis together with all available information in more than 100 external data sources. Based on this estimation, a risk score is given (FRISS Score). The higher the score, the higher the potential risk of fraud.

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Cookie and Privacy Policy

1. Introduction

When you use this website, FRISS may collect information about your use of the website and the content offered. We believe it is important to handle your (personal) data with due care and confidentiality. When processing your personal data, we comply with the General Data Protection Regulation (Algemene Verordening Gegevensbescherming) and Article 11.7a of the Telecommunications Act (Telecommunicatiewet).

1.1.  Controller

The controller of the processing of personal data is:

FRISS Fraudebestrijding B.V.
Orteliuslaan 15
3528 BA
Utrecht

This processing of personal data is registered with the Dutch Data Protection Authority (Autoriteit Persoonsgegevens) in The Hague under reporting number m00004997.

1.2.  Purposes of data processing

There are several places on our website where you can fill in your (personal) data. We will explain the purposes of the various instances of data processing below.

Filling in the contact form or sending an e-mail

If you fill in the contact form on our website or send us an e-mail, we will only use the (personal) data you provide for the purpose or purposes for which you filled in the contact form or sent the e-mail.

Download form

If you download files on our website (such as e-books, whitepapers or reports), we will use the (personal) data you provide for one or more of the following purposes:

  • for the execution of an agreement, for example to send you the e-book, whitepaper or report you have chosen;
  • for the formation of an agreement, for example by contacting you by telephone or in writing.

Newsletter

If you fill in the application form for the newsletter on our website, your (personal) data will be used to send you the newsletter. Each newsletter contains a hyperlink at the bottom of the message that you can use to unsubscribe.

In addition to the personal data you provide to FRISS yourself, FRISS may collect, record and process additional (personal) data if you use the (web) services of FRISS. This concerns the following personal data:

  • data from the used equipment, such as a unique device ID, version of the operating system and settings of the device you use to access a service;
  • information about the use of a service, such as the time at which you use the service and the type of service that is used;
  • location details from your device or derived from your IP address that is provided to us when you use a particular service;
  • data available from external sources. We may receive information about you from public or commercially available sources.

1.3.  Provision of (personal) data to third parties

Your (personal) data will never be provided to third parties without your permission, unless we have an obligation to do so pursuant to legislation or regulations or you have given permission for this.

1.4.  Security of data

FRISS respects your privacy and ensures that personal data are handled confidentially and with the utmost care. All processed (personal) data is stored exclusively in secure databases. These databases are only accessible to employees of FRISS, to the extent that this access is required by virtue of their position. FRISS makes every effort to secure these systems against loss and/or any form of unlawful use or processing.

1.5.  Inspection, correction and deletion of data and the right to object

You can view your data that is processed by FRISS at any time and free of charge and, if you so wish, modify this data or have it deleted. You can also object to receiving information about products, services or content of FRISS. If you wish to make use of one of these options, you can send an e-mail to the Data Protection Officer of FRISS via privacy@friss.eu or write to the following address:

FRISS | fraud, risk & compliance
Attn. Data Protection Officer
Orteliuslaan 15
3528 BA Utrecht.

2. Cookies

When using this website, information about your use of these services and other websites may be collected by or on behalf of FRISS, for example by means of cookies.

A cookie is a small file that is sent along with pages of a website and stored by your browser on the hard disk of your computer. We use cookies to remember settings and preferences. You can disable these cookies via your browser.

2.1.  The purposes for which FRISS uses cookies

On our website we use cookies for the following purposes:

  • for statistical purposes, in order to analyse the use of FRISS websites. This allows us to keep track of the number of visitors and see which parts of our website are popular. We use Google Analytics in order to track and consult these statistics. On this website you can find explanations about all cookies that may be placed by Google;
  • for what is known as ‘targeting’ purposes, if you have used the download form. By targeting we mean building a profile of you based on your surfing behaviour on our website, after which we may contact you by telephone or e-mail based on the interests you have shown in order to offer you FRISS services that you may be interested in. We use HubSpot in order to track and consult these statistics. On this website you can find explanations about all cookies that may be placed by HubSpot;

3. Changes to this Cookie and Privacy Statement

FRISS may make changes to this Cookie and Privacy Statement. All modifications will be published on this page. We advise you to consult this Cookie and Privacy Statement regularly, so that you are always aware of the content of the current Cookie and Privacy Statement.