Insurers and service providers alike continue tointensify efforts to combat the multi-billion-dollar fraud pandemic, adopting fresh strategies and utilizing increasingly sophisticatedtechnologies.

For their part, technology providers are fine-tuning and expanding their offerings. In keeping withthis, ISCS has made enhancements to the claims componentof its modern enterprise suite, SurePower Innovation.

“Claim[s] management is an expensive process for insurers, madefurther complicated by an increase in the frequency and severity offraud over the last several years,” said Doug Moore, CTO atISCS. “Any steps we can take through SurePower Innovation to helpinsurers alleviate costs associated with claims fraud are certainto be beneficial and well-received by ISCS customers.”

This latest version, SurePower Innovation Claims 3.0.6, includesvarious features designed to accelerate fraud detection:

• Rule-based ranking of the probability of fraud for a specifiedclaim. The capability for users to add company-specificrules to the framework.
• Alert creation for potentially fraudulent claims as theyare adjusted and paid.

One noteworthy feature of the enhanced fraud detectionframework is the ability to create a fraud score. According toISCS, this means that during the evaluation of an actual claim, aclaimant or policyholder's fraud score is calculated basedon a number of factors, including how many claims weremade against the related policy in the last 12 months, as wellas the dates of the claims.

As with other modules within the company's SurePower Innovationsuite, SurePower Innovation Claims can be implementedindependently or as a suite and is available as a complete managedSaaS solution in the cloud via the ISCS SurePackage deploymentoption.