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Bringing Efficiency in

Fraud Case Management

with the Comprehensive Feature Set of FraudOps

Insurance Fraud Management Workflow

95%

Decrease in Outstanding
Referrals

50,000+

Settled Investigations

£100m+

Fraudulent Claims Managed

10+

Ready Integrations

Industry Challenges

with Traditional Methods of Fraud Case Management

Lack of Visibility & Tracking

Organisations struggle to track the volume and types of fraud cases, especially those retained or referred back, leading to inefficiencies, increased costs, and poor customer experiences.

Manual & Inefficient Processes

Fraud investigation teams rely on manual, inefficient processes, such as copying and pasting data into multiple systems, resulting in inflated caseloads and slow case resolutions.

Quality & Case Analysis Challenges

Difficulties in reviewing fraud case analyses and tracking fraud handlers' work quality lead to inefficient case reviews and poor decision-making.

Lack of Data Mining & Referral Feedback Tools

No feedback tool exists to evaluate the value of referrals or intelligence. Searching for linked entities within multiple fraud cases is cumbersome due to reliance on external data feeds.

Communication & Case Prioritisation Issues

Urgent cases are manually managed without prioritisation, and identifying linked fraud cases is time-consuming and labor-intensive.

System Integration & Intelligence Management Gaps

Lack of a centralised intelligence hub makes storing and reviewing fraud-related intelligence difficult. Additionally, visual tools for identifying linked claims are absent.

Better Visibilty & Tracking

To enhance oversight of fraud case volumes and types, especially retained or referred-back cases, the Fraud Referral Report provides valuable insights by offering:

Enhanced Sales Analytics Concept Art
Real-time visibility & tracking
Gain instant insights into all fraud cases, eliminating blind spots.
Digital wallet with money and cards
Significant Cost reduction
Minimise unnecessary expenses by streamlining fraud investigations.
AI-powered fraud detection abstract art
Enhanced fraud detection
Improve efficiency and accuracy in identifying fraudulent activities.

Automated & Efficient Processes

By replacing manual and inefficient processes that increase caseloads and slow down case resolutions, the Referral Portal with a 360-Feedback Loop enhances efficiency by providing:

Detective analyzing fraud case data
Unified platform
Consolidates case data to reduce fragmentation and improve accessibility.
Process automation
Minimises manual effort and streamlines fraud investigations.
360° feedback loop
Enhances collaboration between fraud handlers and referrers for efficiency.

Enhanced Quality & Case Insights

Challenges in reviewing fraud case analyses and assessing the quality of fraud handlers' work can result in inefficient case evaluations and poor decision-making. Audit Logging & Case Review improves this process by providing:

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audit logging
Tracks audit histories for transparency and compliance
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Clear system access
Provides fraud handlers with secure and structured case visibility
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Real-time reporting
Generates actionable insights to support better decision-making

Improved Communication & Case Prioritisation

Manually managing urgent cases without prioritisation and identifying linked fraud cases can be time-consuming and labor-intensive. The Case Allocation & Triage System addresses these challenges by:

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Urgent case prioritisation
Marks high-risk claims for immediate attention.
Triage filtering
Identifies and manages high-priority fraud cases efficiently
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Easy case linking
Connects related cases to ongoing fraud operations for better coordination.

Seamless System Integration

Most tools lack integration with other systems, and visual tools for identifying linked claims are absent. FraudOps resolves this by providing:

platform integration
Seamlessly integrates with top platforms like Telesign, Experian, Creditsafe, LexisNexis, HeadsUP, and SymphonyAI.
Abstract vector of merging companies
Enhanced cross-case analysis
Groups related fraud cases together for deeper and more comprehensive cross-case insights.
Business intelligence dashboard view
Smarter fraud investigations
Enhances operational efficiency by identifying connections and patterns more quickly.

Better Intelligence Management

Without a centralised intelligence hub, storing and reviewing fraud-related intelligence becomes challenging. FraudOps solves this by providing:

Insurance fraud case management tools
Centralised data storage
A unified hub ensures easy access and retrieval of fraud-related intelligence.
Insurance Fraud Detection Illustration
Fraud Pattern Recognition
Investigators can seamlessly connect cases and identify fraud patterns.
Team analyzing insurance fraud cases
Efficient intelligence review
Quick access to past fraud intelligence that improves decision-making.

Effective Strategies for Fraud Management at Your Fingertips

Learn about the effective strategies to combat insurance fraud
with proven operational approaches and best practices. Optimise fraud management, prevention, compliance, and risk mitigation today!