ClaimShare Backtesting: quantify possible double-dipping fraud

Learn how ClaimShare Backtesting uncovers the scale of the duplicate-claims problem

Summary

• Duplicate claims fraud is estimated to cost insurers billions of dollars each year
• But it is a difficult problem to quantify without a solution that can first accurately detect cases
• ClaimShare Backtesting allows insurers to assess lost value by detecting historical duplicate claims
• Backtesting was conducted that underscored ClaimShare’s accuracy and potential to save national insurers millions in avoidable losses

Duplicate claims cost insurers billions of euros each year, but without detection, it is an invisible problem. Now, however, it is possible to identify the number of potentially fraudulent claims insurers typically receive using ClaimShare Backtesting.

1. A major European insurer signed on for Backtesting with ClaimShare
2. The insurer provided claims data in 5 pre-selected datasets
3. ClaimShare was used to detect duplicate claims

Results of Backtesting

Backtesting took only minutes and detected 100% of the duplicate claims attempts.

Results were in-line with KPMG estimates for the percentage of claims that are likely to be duplicates — roughly 10% of all fraudulent claims.

Not only did ClaimShare process all claims from the 5 pre-selected datasets quickly, but the solution proved perfectly accurate, detecting all duplicates.

This, in turn, made it possible to quantify the financial benefit of detecting the fraud attempts for the insurer. In this case, if used, ClaimShare would have saved the insurer €2.7 million within only the pre-selected data.

As the Backtesting did not include the totality of this insurer’s annual claims, nor of other national insurers, quantifying the significant potential savings for a market-wide consortium using ClaimShare was not possible. It is clear, however, that substantial value would be found through deploying ClaimShare and detecting duplicate claims at this scale.

Companies interested in participating in Backtesting are invited to contact ClaimShare’s Product Manager, Steven Eliaerts via the company website.

To perform Backtesting, the ClaimShare participant simply needs to:

1. Extract the claims dataset for the agreed business line
2. Standardize the PII-Data in the claims dataset to the required data formats
3. Upload the claims dataset to your personal secured ClaimShare environment

Please book a demo for more information on either the ClaimShare solution or Backtesting.