Stop revenue losses due to insurance claims fraud
Every year insurance companies face the daunting task of sifting through millions of transactions to stop the billions in losses due to fraud.
Both individuals and organized crime rings rely on schemes like identity theft, false worker’s compensation and medical claims, social security fraud and intentional vehicle accidents to scam millions.
Alessa uses advanced techniques like machine learning to detect suspicious claims and fraudulent activities that trigger investigations before being paid out. Features of the solution include:
Monitor all transactions to intercept suspicious activities for investigation
To detect complex fraud schemes across departments and systems
Configurable assessment of vendor and customer risks based on profile and activity
Studies estimate that fraud accounts for up to ten percent of incurred losses and loss adjustment expenses by the insurance industry. Alessa helps to significantly reduce these losses and exposure and enables insurance companies to keep their premium rates low.
In many jurisdictions, insurance companies are required by law to set up programs that identify fraud and take actions to reduce it.
Use the risk scoring functionality within Alessa to identify the highest risk transactions and prioritize activities of assessors and special investigation units (SIU).
Reducing losses due to fraud, identifying and mitigating against risks and prioritizing the efforts of staff help to reduce operational costs and premiums for brokers and clients.
Screen transactions in real time, periodically or by specific events to immediately detect errors, anomalies or control breaches and report as exceptions.
See how Continuous Controls Monitoring allows management to continually review business processes to ensure that they are meeting their targets for effectiveness.