Claims Solutions

Claim Scoring

Claim Scoring’s precise predictive analytics swiftly and accurately detect claims fraud so you can fast-track settlements.

Demo Claim Scoring

How do you detect fraud while processing claims quickly?

Many claims departments lack the IT resources and broad industry data needed to develop effective fraud analytics systems. But implementing third-party analytics can be expensive and time-consuming. Plus, fraud models can have confusing outputs, wasting SIU time.

Fight claims fraud with predictive analytics

Claim Scoring™ lets you score and evaluate claims quickly and effectively using your own real-time data plus aggregated data from 95% of P&C industry carriers.

Fast, accurate fraud detection

Machine learning and predictive models provide accurate claim scores and reason codes for swift triage, evaluation, or settlement decisions.

The world’s largest P&C claims database

Claim Scoring leverages data from over 1.8 billion claims industry-wide to identify fraudulent claims, surpassing models based solely on your own data.

Respond quickly to emerging risks

Build custom fraud scenarios to test ideas using expert business rules and other data points to create more efficient, flexible fraud detection.

Claims fraud detection that stays ahead of fast-evolving schemes

Discover how Claim Scoring uses machine learning, vast data sets, and predictive models to confidently expedite fraud detection and claim triage.

Claims fraud detection that stays ahead of fast-evolving schemes

Closeup Of Person Using Tablet With Data

Visual insights to improve claims investigations

Dashboards show you:

Scored claims in real time
Deep insights into reason codes used in claim scoring
Questionable claim exposures in your geographical book of business
Insights into loss history dynamics via ClaimSearch^®

Features and capabilities

Claims predictive analytics through AI and machine learning

Claim Scoring uses multiple variables to identify claims for further investigation and uses fraud scenarios to give SIU meaningful context for model output.

Custom fraud rules for efficient claims fraud detection

The sandbox environment in Claim Scoring lets you create and test custom rules, create targeted alerts for your modeling, and collaborate internally with data scientists to optimize scoring.

Access to more than 1.7 billion claims records

Claim Scoring compares claims to records in the world’s largest P&C claims database and leverages third-party data and civil/criminal records.

Related resources

Uncover ways to enhance your ability to detect insurance fraud swiftly and accurately, improving your fraud-fighting capabilities.

White paper

Illuminate unseen claims fraud with advanced analytics

Organized fraud rings target insurers with the weakest fraud detection programs. Is your company on their hit list?

Download the white paper

Brochure

The critical role fraud scenarios play in advanced analytics

Are you getting the right results from your fraud analytics? Learn how fraud scenarios enhance your investigations and improve model output.

Download the brochure

Article

5 questions to ask before building a claims fraud analytics system

With the industry focus on data analytics in insurance, many SIU leaders are considering enhancing team’s investigative capabilities with a fraud analytics solution.

Read the article

Do more with the Verisk ecosystem

Claim Scoring is part of a full suite of solutions that provide compliance, claims development, and deeper fraud analysis tools.

The world’s largest P&C claims database

Fast-track claims while improving fraud detection with access to data from more than 1.8 billion claims.

Learn about ClaimSearch

Fraudulent images in claims identified

This automated process applies a series of algorithms to every customer-submitted loss photo to expose anomalies.

Learn about Digital Media Forensics

Workers Viewing Coordinates On Multiple Screens

Advanced link analysis to fight organized insurance fraud

Discover the hidden relationships and connections among claimants, providers, and businesses.

Learn about Network Analysis

Missing details to complete claims

Get hundreds of supplemental data reports to enhance claim analysis and investigations.

Learn about Research Hub

Medical provider scoring

Advanced analytics and expert clinical oversight to detect medical provider fraud, waste, and abuse.

Learn about Provider Scoring

Contact us to learn more

We are available Monday through Friday, 7 a.m. — 8 p.m. US Eastern Time:

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Note that password resets and user information are not available through Live Chat or Email. Instead, please call the main toll-free number below.

Main toll-free:

1-800-888-4476

Global toll-free:

International Access code, then 800 48977489
When calling from the UK, please dial 00 800 4897 7489

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