Defending against fraudulent insurance claims is not only a legal obligation for insurance companies, but also an enormous lever for the effective reduction of loss expenses. The average claim for a fraud case, for example, amounts to approximately €6,500 in motor vehicle liability damages.
The establishment of a software-supported fraud detection solution can be a first milestone in the implementation of a successful strategy to prevent fraudulent claims. The keyword is ‘can’ because software does not immediately generate savings. These are realised in the second step through optimised control and by selecting the right cases for further processing, i.e. with professional investigative work and excellent service provider management.
adesso’s own fraud detection solution – a|advanced fraud management (AFM) – has a high-performance expert system that enables the automated evaluation of claims and is available as both an on-site and cloud-based service. Due to the distinctive interface capability, it is possible to connect it to and integrate it into almost every system or service. A downstream expert system also supports the further processing of suspected fraud cases.
In order for fraud cases to be optimally handled, adesso offers the following solution approaches: