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Monday, November 07, 2005

Insurance fraud is increasing more each year, with the abuse particularly impacting health, workers' compensation and auto insurance lines

Insurance fraud is increasing more each year, with the abuse particularly impacting health, workers' compensation and auto insurance lines. Fraud ranges from sophisticated crime rings involving multiple parties to cases where individuals or medical health providers act alone to abuse the system.

In response, a growing number of insurers have begun to implement sophisticated fraud detection tools to support manual methods and combat what experts estimate is an $80 billion annual problem for U.S. insurers. Fraud management technology that uses predictive modeling to identify suspicious claims can accurately cull out high-risk claims and label them at the earliest possible moment. It not only makes it practical for insurers to process and close the vast majority of claims faster, it focuses the adjusters review on claims that require the most attention. Lastly, it provides higher quality referrals to investigative units.

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