Force Fraud Detection

Make Decisions on Suspicious Claims More Quickly and Accurately.

Force detects fraud with twice the accuracy of other solutions.

Force is a powerful, AI-powered fraud detection solution. This automated, SaaS-based solution flags potentially fraudulent insurance claims across all lines of business with a 75% hit rate.

Analyzing claims in real time or in batches, Force makes reviewing flagged claims and taking informed, data-driven actions easier for claims handlers. With Force, you’ll see a comprehensive, prioritized set of suspicions underlying each fraud alert in a single, easy-to-navigate dashboard.

Get the solution sheet
  • Force effectively identifies:
  • Individual claims fraud suspicions across all lines of business

  • Network fraud from organized crime groups and others

  • Potential provider fraud

  • Likely internal fraud and other suspicious behaviors

  • Force helps insurers:
  • Stay ahead of emerging fraud scenarios

  • Improve investigative efficiency

  • Reduce fraud losses

  • Lower false positives

How it works

Force is built on AI from the ground up. It analyzes insurance claims across all lines of business, identifying potential fraud and providing actionable guidance to help claims handlers and investigators make better decisions faster.

Fast onboarding,
guided configuration

  • Data Scientist-led configuration
    in as little as four months
  • Historical claims data ingested
    and cleansed
  • Denoised data made available
    to every client
  • Initial fraud scenarios developed, calibrated and tested

Accurate, actionable
fraud detection

Force’s AI analyzes every claim against:

  • Historical claim & policy data
  • Hundreds of fraud scenarios
  • 3rd party data, including social
    media, geolocation & mapping,
    weather, credit & financial, criminal
    history, public images

Specific investigative guidance

  • Clear, prioritized fraud suspicions
  • Flags for network fraud by organized crime groups
  • Alerts for potential provider fraud, including repair shops, physicians, and attorneys

Backed by Shift Data Scientists

  • Insurance-focused Data Scientists tasked with maximizing ROI
  • Continual updates to fraud scenarios to reflect trends
  • Ongoing research and product enhancements

01

Force takes a global view of insurance fraud.

Force has analyzed hundreds of millions of insurance claims globally since its inception in 2014. This extensive dataset gives Shift clients unmatched insight into the techniques and tools fraudsters are using — knowledge that helps them defeat fraud more effectively every day.

Shift Technology is a strategic partner for us and we are working together to achieve our goals.

Mitsui Sumitomo Seguros (Brazil)

Accurate fraud detection is the key to automated claims decisions.

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