FRISS Fraud Score Integration for ClaimCenter 9.0.4

FRISS Fraud Score Integration for ClaimCenter 9.0.4

SKU A-10606
UOM Each

Ready for Guidewire

The goal of the FRISS accelerator for ClaimCenter is to enable fast-track claims with automated red flags, hereby helping claim adjusters to focus on the suspicious claims only, providing support to detect and investigate fraudulent claims.

Risk Management is very important for an insurer, including the estimation of the risks of a claim being fraudulent. This can be done manually, via certain in-built rules or using a separate tool. The best results however are accomplished with a seamless integration of automated risk assessment within the claims process itself. This is exactly the idea behind the FRISS Accelerator for ClaimCenter.

The FRISS Fraud Detection at Claims accelerator seamlessly integrates ClaimCenter with FRISS. FRISS will automatically check every claim for potential fraud and risks at various stages of the claim in ClaimCenter and the results are made available to the claim adjuster in a white box setting. The claim adjuster will be able to handle and adjudicate most claims within ClaimCenter, based on the information that is accessible within the Accelerator.
The FRISS accelerator helps insurers to lower the loss ratio on claims via the detection of possible fraudulent claims, not only by avoiding claim payments but it also via a higher percentage of claims withdrawal.

The Ready for Guidewire accelerator speeds up the already short implementations of the FRISS solution at insurers and considerably lowers the implementation costs and resources involved. The accelerator can also help in the carriers’ efforts for straight through processing (STP). Based on the FRISS results, decisions can be made for the further claim handling process