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Insurance Fraud: Part 3 – 6 Tips To Prevent Insurance Fraud

January 8, 2021
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Six tricks to prevent fraud 

Through this series on how to prevent insurance fraud, we’ve gone over what fraud is, and how can technology help prevent fraud. This is the last entry. It’s time to take action to prevent insurance fraud. Read on for our 6 tips to stop fraud in its tracks.

1. Automate 

Through machine learning you can create workflows that automatically check information provided by the parties involved. 

2. Use Data to detect fraud 

Data analytics is the key to detecting fraud. Basically, adjusters enter data, and claims are automatically given a Suspicion Score to indicate the likelihood that fraud has occurred. The technology behind this involves data-mining tools and quantitative analysis. 

3. Continually review and rescore claims 

Historically, monitoring Suspicion Scores has been more accurate and effective than traditional fraud-detection methods. This is because combating insurance fraud takes persistence and good timing.  

The best part – these tools can be automated! This prevents the need for manual analysis and sends alerts with important items to review.   

4. Adopt a layered approach 

A layered approach means using a variety of tools and technologies to tackle a challenge. This is the industry’s organized way of exhausting all resources.   

The Modern Insurance Organization has a library of tools used to detect fraud. These include videos, photos and even livestreaming to document evidence at a car crash or crime scene.   

A virtual gold mine lies within data. It’s imperative to collect, organize, and index the data for fraud detection.    

5. Stay on top of new fraud practices 

As fighting fraud becomes more proactive, insurers must spot new trends to stay ahead. To be on top of the latest trends, think about everything 2020 has taught us. For example, “digital culture” has become the norm. How do you prevent fraud in a digital environment?  

6. Fight fraud through prevention 

Maintaining control, streamlining processes and analyzing claims can happen seamlessly with a cross-referencing tool. 

TerraClaim is an anti-fraud smart tool that will give adjusters the freedom to be more productive and effective. Learn more about preventing insurance fraud with the TerraClaim software at https://terraclaim.com/. 

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  • Solutions
    • Claims Management
    • Policy Administration
    • Claims Benchmark
    • Connect Marketplace
    • Compliance Management
  • Who We Serve
    • Third-Party Administrators
    • Carriers
    • SIFs and SIGs
    • Captives
    • Managing General Agents
    • Medical Services Providers
  • Blog
  • Request A Demo
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