The Insurance Information Institute estimates that fraud accounts for 10 percent of the property/casualty insurance industry’s incurred losses and loss adjustment expenses each year, and over a five-year period from 2009 to 2013, property/casualty fraud amounted to about $32 billion each year. Also, the Federal Bureau of Investigation said that healthcare fraud, both private and public, is an estimated 3 to 10 percent of total healthcare expenditures and the U.S. Department of Health and Human Services’ Centers for Medicare and Medicaid Services’ data for 2010, healthcare fraud amounted to between $77 billion and $259 billion. Healthcare, workers compensation and auto insurance are believed to be the lines most vulnerable to insurance fraud. But the nature of fraud is constantly evolving. Unfortunately, While it is generally acknowledged that technology-based solutions can provide advantages in fraud detection, insurers still face challenges in deploying technology projects. Challenges include lack of IT resources (38 percent), cost/benefit analysis (36 percent), proof of concept and unknown effectiveness (14 percent), acquisition and integration of data (seven percent), and legal and compliance issues (five percent).  How can we help you respond?

New Technology to Combat Fraud: Advances in analytical technology are crucial in the fight against fraud, predictive modeling, text mining, link analysis and big data analytics  are part of anti-fraud strategies. Data-mining programs, which scan many insurance claims; Systems that identify anomalies in a database can be used to develop “rules” to automatically stop claims and analytical programs  that can search various kinds of data formats for key terms and word patterns. ​

Ascends’ Security and Fraud  Solutions:  Our team works with insurers  to optimize their fraud detection processes and to help improve the their return on investment in fighting fraud. We can also help insurance companies develop a claims  analytic’s platform that uses a common infrastructure and provide access to the skills, expertise, leading-edge thinking,  and tools that can help enhance fraud detection capabilities, as a managed service or  project. Our work includes  assessment  of existing fraud detection capabilities, new technology  recommendations and process  improvements that fight fraud and deliver real, tangible results.