The statistics on claim fraud are astonishing. According to the Canadian Coalition Against Insurance Fraud, fraud costs the insurance industry between 10 to 15 percent of the total cost of all claims or almost $1.3 billion a year1. Even more astonishing is the fact that more than 12 percent of all paid claims had some recognizable indicators of fraud2 and yet they were still paid.
Why did these indicators fail to trigger investigations? The answer is workload. With the huge volumes of claims to process, it’s virtually impossible for insurers to manually check every single claim for fraud indicators. In addition, up until now there has been very little - if any - fraud detection technology available to the industry.
To help fight the battle against fraud, CGI developed Claim Check - an innovative solution that automatically alerts your automobile claims team of fraud indicators. Claim Check allows you to set predetermined, time-sensitive fraud indicators at any level - policy, claimant, industry - and, once these indicators are set, they are used to evaluate every automobile claim that your company processes. Once Claim Check detects a claim that has enough fraud indicators to warrant a review, it notifies your claims team and prompts them to review the claim for possible fraud. With Claim Check, your team only has to review those claims that warrant review. There is no longer a need for random spot checks.
Summary of Benefits
- Automatic check of fraud indicators
- Ability to define and preset fraud indicators
- All automobile claims reviewed
- Eliminates manual checks
- Reduces the number of claims that require further investigation
- Reduces fraud costs
- Cost effective
- Easy to use and implement