Feel the force: introducing real-time fraud detection in Guidewire ClaimCenter
Fraud detection is high on the insurers’ agenda and the next frontier in their digital transformation journey. With the Accenture/Shift Technology solution, P&C insurers already using Guidewire ClaimCenter (but not exclusively) can now benefit from a seamless integration between claims management and fraud detection. This will enable them to resolve non-fraudulent claims faster by making real-time assessment of the risk of fraud during the entire lifecycle of a claim, and act faster when fraud is detected.
For every claim, the solution provides a fraud score and qualification (suspicious, not suspicious or not enough information) based on a variety of fraud signals.
When the fraud score justifies it, claim handlers are automatically notified and processes are adjusted in real-time (e.g. stop automatic processing). They or fraud experts can then launch more detailed investigations. When no fraud is detected, claims can be fully automated. Insurance staff can easily navigate within a claim, see the reason(s) for the risk of fraud, view related histories (e.g. previous claims of the policy holder or third party) as well as a user-friendly representation of potential “networks” identified (i.e. links between claims and/or people) at key steps in the claim lifecycle.
Watch the video to discover how it works.
“At Accenture we are excited to propose innovative solutions to P&C insurers to accelerate their Digital Transformation leveraging on Shift Technology and Guidewire,” said Nicolas Pireaux, Accenture Managing Director in charge of the Accenture Guidewire capability development practice. “Shift staff’s contribution and Shift’s open APIs allowed Accenture to develop quickly relevant claims agent journeys, preventing fraud risk, while integrating seamlessly exchanges of Policy & Fraud ranking information within the two platforms.”
About Shift / Sophisticated Fraud Detection
Shift Technology powers AI, predictive models, text mining, profiles, rules and algorithms to assess fraud, combining claims and policy data with any other kind of information available, including free text, scanned documents and external data. For example, Shift Technology could determine the relationship between different claims based on the fact that people share the same bank account, live close to each other or attended the same event. All sorts of fraud signals are then checked together to provide a fraud score, which allows insurers to qualify a claim as suspicious (or not) and make the right decisions at the right time, such as keeping the claims fully automated when no fraud is detected.
Moreover, Shift Technology registers the decisions made with regard to fraud so that algorithms learn by themselves, which further enhances the quality of the fraud detection.
Ready to experience this innovation for real?
Accenture has one mission: to help insurance companies successfully navigate their digital transformation journey, leveraging exciting new technologies and our industry-leading partnerships. We’d be delighted to give you a live demo of this Accenture/Shift Technology innovation. Don’t hesitate to contact Antoine Dandois or Benjamin Berton for a chat!