Data quality, legacy systems impact insurance fraud fighting

With more than $34 billion lost in 2017 to fraudulent insurance claims, one of the insurance industry’s highest priorities is protecting themselves from fraud through innovative technologies.

That’s according to the 2018 Insurance Fraud Survey from FRISS, which surveyed 150 insurers. Among the company’s key findings were that the quality of a carrier's data has become increasingly important. Forty-five percent of insurers report a challenge with the quality of fraud data collected, up from 30% in 2016, when only 30% of insurers saw this as a major challenge. Carriers find too little information is available, or poor-quality information is disrupting the process.

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Carriers are also looking to exchange information between each other at a higher rate. With more insurance being sold online, focusing on online interactions makes it more important for firms to have immediate access to quality data to make smart decisions on who to insure. Shared data includes information about false claims, unreliable repair shops and health professionals, imagery and information about insured assets. A third of insurers surveyed now believe it’s an important tool in fighting fraud, reflecting a shifting attitude away from concerns about competition and proprietary information.

Insurers are implementing advanced and evolving technologies to fight fraud more every day, the survey finds. More than 60% of carriers use automated fraud detection software to enable real-time fraud detection. But there are still challenges: While 86% of insurers believe their current systems are up to date, over half have difficulty maintaining their software. A further 43% report difficulty with data integration and find too many false positives leading to delays in the claims process.

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