Case Studies
Erie Insurance Improves Its Detection Process and Stays True to Its Values with LexisNexis® FraudFocus Enhanced
Overview
Analytics & Modeling - Predictive Analytics Application Infrastructure & Middleware - Data Exchange & Integration Application Infrastructure & Middleware - Data Visualization | |
Finance & Insurance | |
Business Operation Quality Assurance | |
Fraud Detection | |
Data Science Services System Integration | |
Operational Impact
Enhanced review: The predictive analytics that drive FraudFocus Enhanced serve to 'level the playing field for adjusters in the review of claims and pursuit of fraud,' according to Erie. The solution fills any gaps in experience and honed intuition between seasoned and less seasoned adjusters, with alerts that spur a closer look. The program also helps sharpen adjusters’ skills over time, as they learn what to look for from the information FraudFocus Enhanced provides. | |
Equal treatment: With FraudFocus Enhanced, claims of all sizes and types are subjected to the same treatment. This means improved efficiency through a tighter screen that keeps smaller, more routine cases from being overlooked or given less scrutiny than larger, more complex claims. | |
Fairness through consistency: As Erie’s corporate values revolve around 'doing the right thing,' benefits such as quality investigations and equal scrutiny of claims are important. So is the consistency FraudFocus Enhanced brings to the process. Its intelligent use of information and predictive analytics means 'fairness across the board' at Erie. The automated program creates alerts based solely on facts in a claim, minimizing the possibility of overlooking relevant and important information, while providing a sound foundation for investigation and pursuit of fraud. | |
Quantitative Benefit
In total, insurance fraud costs more than $96.8 billion a year. | |
Conservative estimates place the cost of property/casualty insurance fraud at $20 billion a year. | |
Health insurance fraud estimates top $61 billion a year. | |