Claims Fraud Case Management

Claims Fraud Case Management: Total strategic control and flexibility

Create and manage your preferred teams, designing investigator profiles that highlight skill sets, experience levels, and brand-specific training. Direct claim investigations to the best people in your organisation, whether you choose to allocate cases yourself or let our auto-allocation engine assign them based on the factors you define.

Improve operational efficiency by giving your investigators instant access to the information they need to make better decisions. Set goals at both the individual and team levels, and leverage our world-class reporting, analysis, and insight capabilities to guide you to success.

A meticulous solution

Define and manage strategic and tactical operations focused on known operators or syndicates. Describe methods of operation (MOs), assign related entities, and track actions taken to date. Instantly connect ongoing investigations to operations for continued oversight. Enables collaboration across specialist functions to achieve outcomes on investigations.

Ensure compliance by maintaining a meticulous paper trail for each case, documenting activities and events as they are recorded. Fulfil your obligations to relevant codes of practice by maintaining awareness of vulnerabilities, adhering to customer contact protocols, and meeting information requirements. Seamlessly manages delegated authorities. This rich data enables audits across all your external partners.

Like all our applications, our case management modules can be used independently or as an integrated part of our broader solution, providing the flexibility and scalability you need to effectively manage claims fraud investigations.