Double-dipping insurance fraud detection

  • 1/3 of insurance fraud is estimated to be detected with 5-10% of fraud consisting of double-dipping
  • Double-dipping is a form of insurance fraud that occurs when one entity files a claim with multiple insurers for the same event
  • Insurers are investing heavily in fraud prevention mechanisms, but are limited to their internally-generated data for these purposes
  • There is no industry data sharing standard and there are heavy regulatory constraints for sharing sensitive, personal information
  • ClaimShare offers a duplicate fraud claim verification solution across insurers, significantly decreasing the number of fraudulent claim payouts
  • By enabling insurers to put public claims data on the ClaimShare ledger after verification, other insurers can check if their claim has already been paid out at another insurer
  • If a suspicious claim is detected, the private data is compared using Conclave to confirm or deny the fraud
  • Why Corda and Conclave? Corda was chosen for its high scalability and throughput and Conclave for its ability to easily build privacy enhancing applications that protect at the hardware-level
  • When implemented, IntellectEU expects ClaimShare to save insurers up to 10% of their overall fraud costs per insurance line
  • It will give insurers a clearer idea of the losses from double-dipping fraud, which are not currently detectable due to lack of reporting
  • Creates real-time reporting on the amount of double-dipping fraud insurers paid out in previous years
  • For the first time insurers can now quantify this type of fraud in a matter of weeks