Tag Archives: claims fraud

Is fraud too big to handle?

Cyber-security

Representatives from property and casualty insurer CNA, Los Angeles County and health systems consultant OptumInsight painted a bleak picture about fraud in their industries. Numbers like $30 billion were suggested, and that was just insurance fraud.

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Predicting motor vehicle insurance claims fraud

Cyber-security

Mark Schneider and Chase Zieman work with the Highway Safety Committee at Louisiana State University. They won the Analytics 2012 poster contest by demonstating how to predict insurance claims fraud.

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Drawing the line between fraud and abuse in PIP claims

James Ruotolo, Insurance Fraud, SAS

The IRC has identified expensive diagnostic procedures as “major drivers of overall medical costs in auto injury claims.” These drivers can help fuel medical mill scams and make it difficult to differentiate between suspected fraud and suspected medical billing abuse. Scams such as these are putting pressure on legitimate providers to remain competitive. James Ruotolo has some advice for insurers and medical providers.

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