Don't accept insurance claims fraud as a cost of doing business.
Reduce leakage by detecting more fraudulent claim activity.
Identify suspicious activity and detect subtle patterns of behavior from first notice of loss (FNOL) to approval or denial. Stem potentially large claims fraud losses with visibility to previously unknown schemes, hidden relationships and covert crime rings. SAS Fraud Decisioning for Claims scales to millions of records, pinpointing claims fraud across them instantly using multiple analytic techniques and customized anomaly detection.
Consolidate your view of claims fraud risk across all lines of business.
Built on a single, cloud-native platform, SAS Fraud Decisioning for Claims unites the insurance claims fraud process, from data management to decision and reporting, in an intuitive interface. Its claims fraud control center provides a 360-degree view of the policyholder across all lines of business, so interconnected relationships and activities are visible across claims and policies – enabling collaboration across fraud teams. And SAS Fraud Decisioning for Claims helps you stay on top of claims fraud trends through continuous model improvement and rapid model deployment.
Lower loss-adjustment expenses while gaining greater competitive advantage.
Improve the customer experience on legitimate claims without sacrificing profit. Our sophisticated fraud scoring engine identifies potential claims fraud accurately to facilitate straight-through processing and other claims automation initiatives. Higher detection accuracy reduces false positives, speeds payment of valid claims, and increases policyholder satisfaction. Automatic scoring also prioritizes higher-value claims, entities and networks, while advanced case and intelligence management tools enable more efficient, effective investigations – all leading to a higher ROI per investigator. Storage of all claims settlement amounts allows for future reuse, reducing reliance on internal knowledge.