As Vice President of Product Innovations for the Verisk Claims Solutions group, Jim leads product-innovation development strategy, sales support and consulting for the Verisk Anti-Fraud Solutions Practice. You can contact him at Jim.Hulett@verisk.com.
Photo-based claims estimates have been a growing trend the past few years in the insurance industry, and once the pandemic hit, that trend accelerated significantly.
Insurers are turning to AI to detect claims fraud automatically – but to get the most from their analytics, they need to understand an anti-fraud system.
Taking a closer look at medical billing helps identify pandemic-related issues that can put patients at risk and negatively impact insurers’ bottom lines.
Neural networks, machine learning, multivariate random forest models, and various derivatives of the same are being used to create modern fraud detection models.