January 25, 2013
LONDON, ON, – Three years ago, CarProof began working with i2iQ and 10 participating insurers to develop a unique tool to assist claims departments in identifying potential fraud activity during the claims adjusting process. The result of all this effort is the launch of eSmartClaims (“eSmart”) which CarProof is introducing in January 2013.
eSmart is a real-time screening tool that electronically accesses multiple data sources to collect fraud-sensitive key indicators taken from the claims history of the insured and the vehicle. This data is processed through a rules-based engine to flag if the insured has a high probability of being fraudulent with a claim. If the insured fails the eSmart test, the insurer is immediately notified electronically prior to authorizing the repair work.
One major benefit to insurers is that eSmart will not disrupt the claims workflow and in most cases will not require any IT changes within the insurer’s claims processing system. eSmart is triggered by the assignment the insurer sends to the repair shop. eSmart has been fine-tuned resulting in alerts being forwarded to the insurer for 3-5 per cent of claims.
This tool has been designed as a real-time solution for identifying potentially fraudulent claims as they are processed and is complementary to other industry fraud detection initiatives, which use predictive modeling techniques to identify organized (cross-insurer) fraud rings.
The results of the proof of concept studies and cost/benefit analysis are eye-opening and readily available. Claims departments can contact CarProof to subscribe to a no-obligation trial or to register for an upcoming eSmart focus group session.
Source: Canada Newswire / CarProof
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