Shift Technology Force Fraud Detection

Features Fast, easy onboarding To get started, insurers simply provide historical policy and claims data in any format. FORCE ingests, cleans, and maps the data. Shift Data Scientists manage the process, working closely with clients' internal teams to fine tune the solution before proceeding to full deployment in as few as four months. Leverages the power of your internal data FORCE’s AI-native foundation is built on insurers’ internal data, including claims data, policy information, financial data, loss adjuster reports, damage estimates, medical billing data, photos, and more. Benefits from years of development of fraud scenarios FORCE has been in continual development and refinement since 2014. In that time period, the solution has incorporated massive amounts of existing claims data – from hundreds of millions of claims – which form the basis for more than 200 highly-defined fraud scenarios across multiple insurance categories. Enriches scenarios with robust third-party data FORCE ingests and analyzes information from sources such as weather data, photos, satellite imagery, criminal records data, bankruptcies, liens, judgements, IP addresses, social media data, loss history, and even data derived from automated web crawling of publicly available websites. This supplements the model scoring by creating and weighting new variables, providing unmatched insight into potential fraud. Gathers and interprets unstructured data FORCE analyzes unstructured data (such as claim adjuster notes) using text mining and natural language processing to identify keywords and phrases that are indicative of fraud, leveraging this text analysis to create fraud variables that will be used in scoring the claim. Provides the expertise of world-class data scientists Shift’s team of more than 100 Data Scientists collaborates with clients’ internal business and data science teams to refine a joint approach to fraud detection throughout the entire customer lifecycle. Our transparent approach to the sharing of data (and the variables and scenarios that comprise the detection model) means that customers’ internal data science teams can develop their own rules, scenarios, and features to incorporate into their FORCE configuration. Delivers actionable claim alerts via an intuitive, customizable user interface FORCE provides prioritized, scored individual and network fraud alerts to claim handlers, fraud handlers, and SIU investigators. They can easily view and manage fraud scenarios and indicators, along with third-party data, maps, and network visualizations in a single interface, without having to refer to multiple data sources externally. Investigators can quickly determine the validity of claims and prioritize their efforts where the ROI is greatest instead of wasting time on triage and research. Benefits:

• AI-native SaaS solution
• Built by world-class Data Scientists with deep industry expertise
• Hundreds of fraud scenarios constantly evolving
• Hundreds of millions of claims processed to date
• Addresses individual claims + network fraud
• Transparent Analytics access to scenarios + data
• ROI in as few as four months