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ISO ClaimSearch Draws on Big Data, Predictive Analytics to Fight Insurance Fraud

Staff Writer | March 19, 2015

Verisk Insurance Solutions announces a new solution to the growing claims fraud problem: ISO ClaimSearch DNA. Property/casualty insurers now can better visualize large networks of suspicious activity operating across the industry.

The Insurance Information Institute estimates property/casualty insurance fraud to be more than $30 billion per year. In just one high-profile case, insurers lost more than $400 million to fraudulent claims in a widespread organized ring encompassing more than 100 medical clinics and thousands of patients. Cases such as this signify that organized fraud continues to be highly adaptive and aggressive and point to the advantages of a proactive approach.

 Insurers seeking new solutions to the growing threat presented by organized fraud rings can take advantage of the advanced analytics of ISO ClaimSearch DNA. The tool magnifies the power of ISO ClaimSearch to find patterns of potential fraud in increasingly large data sets and detect entire networks of organized activity among individuals and businesses, including related service providers. 

"Our clients can use ISO ClaimSearch DNA to be proactive and highly efficient in their antifraud operations," says Rich Della Rocca, president of claims and crime analytics at Verisk Insurance Solutions. "Once they see the suspicious networks that could affect their own companies, it gives them a huge investigative and competitive advantage."

Advanced predictive analytics

The patent-pending technology behind ISO ClaimSearch DNA provides a fully automated solution to proactive network detection. The solution's advanced analytics include entity resolution, text mining, network analytics, and predictive models that work seamlessly to uncover hidden relationships across large data sets, score the networks, and prioritize those of interest for each company. ISO ClaimSearch DNA also provides insurers with alerts and actionable intelligence on their suspicious networks and claims for further investigation.

Organized fraud often affects multiple carriers, so companies trying to fight large-scale fraud using only their own data may likely never see the whole picture. ISO ClaimSearch DNA provides an industrywide view and then helps pinpoint the claims and schemes that could threaten individual insurers.

"We're excited to provide all of our customers with a predictive analytics solution that helps identify developing fraud networks as part of our flagship solution—ISO ClaimSearch—which is used by more than 90 percent of the U.S. property/casualty insurance industry," says Carlos Martins, vice president and general manager, ISO ClaimSearch Solutions. "No matter the size of the company, they will now be armed with the power of 'big data' and cutting-edge science to better detect suspicious claim activity from large-scale fraud networks." 

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