Property And Casualty Insurance, Fraud Detection, Claim Investigation, Claim Handling

Improve Insurance Claim Handling and Fraud Detection

For property and casualty insurance companies, the key to customer satisfaction is settling claims quickly. In fact, a survey by Accenture revealed that most property and casualty insurance claimants prioritize the speed of claim resolution over the settlement amount offered (Accenture, 2002).

Reduce claim cycle times and minimize claim handling costs

PredictiveClaims enables you to increase customer service by reducing claim cycle times. And by reducing claim settlement times, you also minimize claim handling costs and loss adjustment expenses (LAE). At the same time, PredictiveClaims helps you conduct more effective claims fraud detection, and make more efficient use of field agents and your special investigation unit.

With PredictiveClaims, property and casualty insurers can:

Quickly approve legitimate insurance claims to improve customer service and minimize loss adjustment expenses and claim handling costs
Identify fraudulent insurance claims at an early stage with a high degree of accuracy-even with large claim volumes
Understand why certain claims are flagged as suspicious, so your special investigation unit know where to focus its investigations
Combine and analyze data from multiple internal and external sources, including federal and insurance industry databases
Integrate with existing claims management systems without extensive customization or lengthy implementation periods

Detect claims fraud at an early stage

With PredictiveClaims, you determine whether claims are legitimate or fraudulent at an early stage—often in the initial customer conversation. PredictiveClaims integrates with your existing claims management system to deliver risk-based scores in real time, along with reasons for the score. Even with very high claim volumes, PredictiveClaims' advanced analytics accurately determine whichclaims to settle quickly—and which require follow-up or investigation.

Improve the productivity and accuracy of claims handling

With PredictiveClaims, property and casualty insurance companies can improve the productivity and accuracy of the entire claim handling process—from first notification of loss to claim settlement—regardless of whether claims are submitted via telephone, fax, mail, the Internet, or in person.

Eight of the top 10 global property and casualty insurers on the 2004 FORTUNE Global 500 list are SPSS customers

For example, a major insurer handles hundreds of thousands of claims annually through its call center. Using PredictiveClaims to combine risk profiles with business rules—such as claim value guidelines—the company is able to resolve the majority of legitimate claims in just one phone call, while increasing the percentage of fraudulent claims detected at an early stage. As a result, the company has reduced claim handling costs by 30 percent—an annual savings of several million dollars. At the same time, the company has improved customer service and satisfaction by resolving legitimate claims in less time.

To learn more about optimizing your claim risk assessment process with PredictiveClaims, contact an SPSS Account Representative today.

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PredictiveClaims™

Improve Insurance Claim Handling and Fraud Detection

Reduce claim cycle times and minimize claim handling costs

Detect claims fraud at an early stage

Improve the productivity and accuracy of claims handling