SIU & Compliance Programs

As claims adjusters are asked to process an ever increasing workload, it seems that claimants are becoming more proficient at malingering and a few at committing outright fraud. Meanwhile, many seasoned and experienced claims adjusters are nearing retirement, younger and freshly trained individuals are there in an attempt to fill their shoes. Unfortunately, as the acquired knowledge and years of experience leave, so does the seemingly innate ability to sense that something isn’t right with certain claims.

When we study the knowledge and years of experience claims adjusters have in reviewing cases and flagging potential fraudulent activity, it is apparent that certain clues filter up to the top. By taking these clues and applying artificial intelligence, with massive amount of data, we can create a system that combines the best of the experienced adjuster and is now available to all adjusters.

When technology is applied to a specific problem, with input from experienced people, great things can happen.