Insurance fraud is an increasing and persistent problem. Insurance fraud causes direct losses to insurance companies, often leading to increased premiums. Analysts estimate that about 10% of insurance claims are fraudulent. However, fighting and detecting fraud requires time and resources which could and should be focused on improving the customer experience for ‘honest’ customers.
The joint Sapiens and FRISS solution adds AI to automatically detect and identify fraudulent claims and stop these from being paid. Leverage claims segmentation to put ‘honest’ claims in a straight-through process (STP), without the need for human intervention, increasing efficiency and customer satisfaction. When integrated with Sapiens core systems, agents and brokers can see the ‘FRISS score’ and color codes automatically. The actionable insights provide a holistic view of each claim and clearly indicate the probability of fraud.