March 2015 – Predicting Fraud

Fraud seems to be a hot topic at the moment and is a great area to apply advanced analytics to assist in the process of identifying potentially fraudulent claimants.

We use a number of techniques to spot these claims. We can analyze the profile of previously identified fraudulent claims, and look for new claims with the same attributes.

We also look at claims which do not fit the profile of  typical claim and therefore should be investigated.  This is potentially a very useful method to identify new fraud practices.

Also we can spot claims which may not be out-right fraud, but may be a claimant being slow to return to work. There are a number of approaches we use to spot these ‘malingering’ claims.

Please see the section on this site entitled ‘Claim Fraud’ for more detail.

For more information email us at info@claimlab.org