NYCM Insurance Implements Verisk Solutions to Detect Fraudulent Claims Quickly and Accurately

ClaimDirector and NetMap for ClaimSearch help to fight fraud proactively through a business intelligence dashboard, triage page, interactive key claim information, and a visual prior-loss timeline.

(Photo credit: Fir0002.)

New York Central Mutual Insurance (NYCM; Edmeston, N.Y.) has implemented Verisk’s (Jersey City, N.J.) newly enhanced ClaimDirector and NetMap for ClaimSearch solutions to assist in the detection of potential insurance fraud.

Jim Potts, VP of SIU, NYCM.

“We wanted the ability to identify potentially fraudulent claims quickly and accurately,” Jim Potts, VP of SIU, NYCM. “We identified ClaimDirector and NetMap as the right solutions in our fight against fraud.”

ClaimDirector identifies fraud indicators at first notice of loss for incoming claims, and the system updates when new information is added, according to Verisk’s description of the product. NetMap provides capabilities that help identify fraud ring networks and other critical connections among a company’s claims and industrywide loss history data.

Verisk says that ClaimDirector can help NYCM Insurance to fight fraud proactively through features such as a business intelligence dashboard, triage page, interactive key claim information, and a visual prior-loss timeline. ClaimDirector is delivered through the new visualized ISO ClaimSearch platform, so customers can implement the solution with minimal IT involvement. NetMap will allow for insights into complex and emerging organized fraud activity within and between claims, according to the vendor.

Carlos Martins, VP, General Manager, ISO ClaimSearch Solutions Group, Verisk Insurance Solutions.

Access to Real-Time Insights

“We evolved ClaimDirector to provide adjusters and SIU teams with a better way to access real-time insights based on our industrywide claims database,” comments Carlos Martins, VP and general manager, ISO ClaimSearch Solutions, Verisk. “ClaimDirector indicates why the claim triggered potential fraud indicators, guiding investigative direction.”

“Additionally, our continued investment in NetMap provides next-generation capabilities to quickly identify and understand the dynamics of organized fraud networks,” adds Martins. “We’re really excited to have NYCM join hundreds of other insurers, self-insureds, and third-party administrators that are using our antifraud analytics to help process meritorious claims faster across all lines of business. NYCM Insurance is showing real industry leadership combating fraud.”

The Future Envisioned: Building a Platform for Digital Insurance 2.0

 

Anthony R. O’Donnell // Anthony O'Donnell is Executive Editor of Insurance Innovation Reporter. For nearly two decades, he has been an observer and commentator on the use of information technology in the insurance industry, following industry trends and writing about the use of IT across all sectors of the insurance industry. He can be reached at [email protected] or (503) 936-2803.

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