(Image source: TDI homepage.)
TD Insurance (TDI, Toronto), Canada’s largest direct-to-consumer insurer, has announced that it is expanding upon its manual and analytics-based fraud detection and prevention capabilities to include FRISS’s (Utrecht, Netherlands) AI-powered fraud risk scoring to better detect suspicious and fraudulent claims during the claims adjudication process. TDI implemented the FRISS Case Management Tool and Claims Fraud Detection solution in 2020, according to a joint announcement. In June 2021, TDI further enhanced this capability with the integration of FRISS into Guidewire Software’s (San Mateo, Calif.) ClaimCenter, TDI’s claims management system. This integration activated real-time fraud risk scoring and flagging of potential fraudulent claims creating faster and improved detection of suspicious claims, according to the statement.
TDI will use FRISS’s automated fraud detection technology to enhances the insurer’s existing fraudulent and suspicious claims detection capabilities, which already includes internally developed advanced AI-analytics to detect fraud, including partnering with Layer 6 and FRISS for best-in-class solutions to combat fraud at each step of the process. TDI is also a participant in Équité Association, a consortium created by and composed of Canadian insurers to fight fraud. The joint statement characterizes these capabilities create a multi-layered approach to identifying and managing fraud and suspicious claims.
“When false or exaggerated claims are processed and paid out, it’s the honest customers who pay for them,” says Sona Mehta, SVP, Claims, Fraud, Legal and Vendor Management, TD Insurance. “AI-driven detection and analytics is helping our detection and prevention teams better understand, identify and more accurately prevent fraud faster. Our investments in this space help better protect our honest and valued customers when they need us most.”
Recognizing Genuine Fraudulent Claims
“TD Insurance has been great to work alongside,” comments Jeroen Morrenhof, CEO and co-founder, FRISS. “In close cooperation, we delivered our automated, AI-driven fraud detection, allowing them to better manage exposure to fraud by accurately assessing claims in a matter of seconds, reducing the number of false positives and recognizing genuine fraudulent claims in real-time. We’re committed to keep delivering results, and I can’t wait to see where this partnership will take us next.”