back-header-r1.png

Insurance Fraud

Humaitrix offers a variety of services and solutions specifically to address issues the Insurance Industry is facing:

Analytics as a Service

  • Policy and Claims Fraud Analytics
  • First Party Fraud and Know Your Customer
  • Synthetic Identity Fraud
  • Identity Theft
  • First Notice of Loss (FNOL) Analytics
  • Social Network Analysis Risk Scoring
    • Internal Networks
    • Internal and External Data Networks
    • External Social Media Network Analysis
  • Provider and Supply Chain Vendor Fraud Analytics
    • Collusive Provider and Individuals
    • Organized Criminal Activity
    • Crash-for-Cash Schemes
  • Fraud and Abuse
    • Medical Benefits
    • Property and Casualty
    • Commercial Benefits

Solutions as a Service

  • Entity Scoring
    • Provider
    • Individual
    • Claims
    • Social Network
    • Aggregated Risk Scores
  • Maturity and Capability Assessment
    • Assessment of Analytics and Operational Capabilities
    • Operational and Analytics Strategic Consulting
    • Operating Models and Enterprise Implementation Design
  • Gap Analysis and Risk Assessment
    • Roadmaps that identify fraud, waste, abuse, and compliance risks along with the necessary steps to close those gaps

For all of our solutions we offer professional services that provide segmentation, triaging strategies, analytical and operational workflows, communication plans, quality assurance programs, and training.

Fraud is expected to increase to an all-time high over the next few years. It is becoming more pervasive and complex. Our team of fraud experts is here to help you navigate the challenging and evolving threat landscape.