With roots to the police, international investigation bureaus and scandinavias biggest insurance company, the DetectSystem team have built a DetectionEngine that help insurance companies uncover significant amounts of fraud. And thats not all: we help our customers lower operational costs and improve their customer satisfaction.

Spend 6 minutes to see how we can help insurance companies find more fraud, increase claims efficiency and improve customer satisfaction

FDS provides disruptive evidence-based fraud detection, inspecting PDFs, Photos and Videos in milliseconds

 

Are any of these submitted claim documents fraudulent?

The FDS Detection Engine

FDS is a Detection Engine that utilizes 100+ detection methods to determine if a claim document is fraudulent. FDS is evidence-based and provides a reliable answer in seconds, enabling insurance companies to uncover fraud on claims that are below a threshold, too costly to investigate manually today.

Claims processing in the modern insurance space often remains a manual, inefficient and error prone operation. It can easily take a trained forensic expert 15 minutes to one hour per submitted claims document and might still be imprecise, leaving room for fraud in anything from 5% to 10% of all claims.

With FDS, we help insurance companies with three objectives:

Improve fraud detection rate

Improve the combined ratio by detecting fraudulent claims and reducing pay-outs.

Improve operational cost

Deliver automation to ensure improved combined ratio, customer satisfaction and that resources are only spend on evidence-based fraud.

Enhance customer value and loyalty

Driving Data Innovation and facilitating a secure REALTIME STP strategy with fraud detection.

A study conducted by the German insurance association (GDV) concluded that more than half of all claims arising from loss or damage to smartphones or tablet PCs could not have arisen and therefore must have been fraudulent to some extent. As these typically fall below a certain threshold of fraud detection, this means that the fraud findings today are just the tip of the iceberg.

Key Features

FDS is a on-premise software solution developed to perform forensic authentication and fraud detection on individual claim documents in seconds. FDS examines claim documents, utilizing more  than 100 detection points to determine if a file is an unaltered original, an original generated by a specific device, or the result of manipulation through editing software. FDS also determines if a file’s geolocation data aligns with the correspondent claim details. FDS has the capability to evaluate a vast array of file types, including images, invoices, receipts, certificates, health records, employment contracts, warranties and more.

Intelligent Dates Cross-checks

FDS will detect all dates and timings encapsulated in the metadata and verify in accordance with taken-expectations, as well as firmware, GPS dates, ICC-header and profile, runtime since power-up, etc.

Advanced Location Detections

GPS location, satellite communication and GPS within four ranges are verified according to event location or the policyholder’s home address

Software and Editing Programs

FDS detects if claim documents have been through any suspicious software or editing programs, and can highlight new annotations, fonts and modifications

PDF Deep Inspection

FDS analyzes PS source code of PDF files and takes all layers apart to detect any manipulation

FDS DataPoint

The FDS DataPoint will detect if  documents have been used before in other claims (internally or externally). The database shares firmware, camera lenses, locations and other content

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Device and Firmware Release

FDS has a database consisting of +60,000 firmware and device release dates, to verify that a device or firmware was released before a claim document was created

Internet Presence Checker

FDS will detect if a claim document has been downloaded from social media or if the document or a part of the document resides on the web

E-Learning platform

Full featured e-learning platform with user questionnaires and tests, including certificates to print out when passed

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Our patent-pending technologies helps our customers combat fraudulent policyholders in the long run

Document Uniqueness

A revolutionary uniqueness validator, making FDS able to discover DataPoints no matter the file type.

Document Authencity

Utilizing forensic methods to comprise document data within the document itself

Product Ownership

Get notified in case policyholders return a item they have claimed stolen

Interrogation Robotics

Fraud is expected to double with the rise of automation. Ensure a Secure STP transformation with the FDS Claims Robotics. Real-time STP claim validation with anomaly resolvement.

Improve combined ratio, lower claims leakage and enhance operational efficiency

We believe digital automation is an emerging core component for insurance companies today. We also know that change doesn’t always come easily – which is why our expert team is happy to demonstrate how FDS can help you improve operational cost significantly. Our robots finds the needle in the haystack, and you can focus on quicker settlements to raise customer satisfaction.

Claims Management accounts (on average) of 28,5% of the operational cost*

Claims processing is a costly and time-consuming process, with an average of 8 submitted documents per claim, results in submitted documents in the millions every year. The majority of submitted documents are perfectly fine and need no further attention, however, to find the fraudulent claim documents, all documents need to be looked at, it is like finding needles in a haystack.

Not wasting time for both the insurer and the policyholder is of essence. To manually validate the validity of a submitted photo or pdf. easily takes a claims handler 30-50 seconds per document without any digital analysis for fraud. Just to open a submitted file, make sure the name and date corresponds with the claim, save and close the file is a very time-consuming manual task.

 

It doesn’t help if the policyholder digitally has manipulated the submitted documents, resulting in more fraudulent claims going undetected. The real waste is time spent on the 90-95% of claims where the submitted documents are perfectly fine, where there is no need to spend 30-50 seconds per submitted document, which adds up to thousands of wasted manhours every year.

*According to McKinsey, automation can reduce the cost of a claims journey by as much as 30%.

To stay competitive, insurance companes need to transform their operating models

The value proposition FDS includes protecting the insurance community against the abuse of premium funds.

The highly regulated insurance industry need automation as a fast way of applying superior capability to the problem of improving their combined ratio. FDS gives insurers better customer service because of speedy claims handling. The majority of volume heavy insurance transactions such as claims processing and document verification is being performed by humans. FDS automated document verification effectively recognizes, and fight fraud at its core and insurers can free staff to deal with the more complex claims. The claims division is very busy, with claim backlog needing processing, that is why employees welcome the FDS technology because FDS relieves them of the rising pressure of work and helps them with the increased number of claims documents that needs to be carefully examined. 

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FDS robotics relieves the stress and gives back a huge number of hours to the business. It’s not just the shareholders, the senior managers, and the policy holders who benefit but also employees in claims management. FDS will have a positive impact on productivity and means people will have more interesting work.

The future of insurance claims management and KPI’s  

Insurance organizations are under constant pressure to offer improved services at reduced costs, for claims management in particular. Policy holders embrace digital technologies, and FDS Claim Robotics deliver a strong return on investment (ROI) not only in direct fraud findings but also in the many submitted claim documents with no need for human interaction. FDS advancements simplify insurance processes considerably, and the biggest savings are in the reduced operational cost. FDS envision a smarter future for both insurers and policy holders.

In this example 1,723 claims were processed including 14,473 submitted claim documents. FDS resolved a potential of 124 fraudulent claims (57 fraudulent and 67 need further investigation). More importantly 1,599 claims didn’t raise any alerts and therefore needed no human interaction.

If a claim handler in this example should only verify (not fraud detect) 14,473 documents manually (x 50 seconds each) this task would have taken a trained claim handler more than 200-man hours. FDS handle approximately 2 documents per second.

AutoLoad Robot

FDS AutoLoad Robot-I ensures comprehensive document checking on all claims. Use the mailbox integration or load directly via fast and easy-to-setup integration hooks , integrate via exchange of JSON files or utilize the WebAPI.

Claim Robotics

STP is hard to do in a safe manner without a technology that verifies submitted claim documents, which is a critical part of and forms the basis for the claims pay-out

FDS WebAPI

The FDS RESTful API is built to ensure that the FDS Detection Engine enables a secure STP environment and integration abilities with any system. Learn much more on a live demonstration.