Shift Technology, a provider of AI-powered decision optimization solutions for the global insurance industry, has officially announced the launch of its Insurance Data Network (IDN).
According to certain reports, the stated network will make it possible for members to leverage industry-wide intelligence, which it acquires using the collaborative multi-carrier exchange of claims and related data. Hence, all the participating insurers can come expecting valuable insights and analysis to enhance fraud detection and risk prevention throughout the entire claims lifecycle.
To understand the significance of such a development, we must take into account a report from Coalition Against Insurance Fraud, a report where it was revealed that insurers record nearly $122 billion in P&C insurance losses annually due to fraud, with almost 10 percent of claims exhibiting signs of fraudulent activity.
In fact, going by early results IDN indicate that when cross-carrier data is analyzed, identified fraud networks have, on an average, tripled in size.
“Insurers are continuously working to stay ahead of fraudsters as they recognize that their fraudulent activities extend beyond the scope of a single insurance company,” said Karlyn Carnahan, CPCU, head of insurance, North America, Celent. “Until recently, insurers had limited tools to understand behaviors of fraudsters beyond their own experiences. However, with this new ability to gain visibility, analyze, and extract insights from shared experiences across the industry, insurers have now regained control and power in fighting fraud.”
Another detail contextualizing the importance of this network is rooted in the fact that claims handlers, more often than not, are left with the burdensome job of reviewing extensive demand packages and manually analyzing lengthy claims data to identify any relevant or actionable information.
In response, membership in IDN guides insurers big time to automate this process. You see, by leveraging data-driven insights, insurers can quickly determine if current or past PIP/BI claims involve providers, whether medical or legal, who are on the insurer’s internal watchlist or have been sanctioned or suspended.
Such a mechanism empowers claims to be expedited to the Special Investigations Unit (SIU) or referred to medical management for further review.
Not just that, unlike your typical legacy systems, IDN allows members to retain full ownership and control of their data, meaning information is never sold back to members or resold to third parties. Compared to traditional systems, IDN also provides a more comprehensive set of claims data and related intelligence. This it does to offer deeper context for fraud detection and risk assessment.
“IDN empowers insurers to get more value out of their data by providing a secure environment in which to share it and collaborate with other carriers,” explained Jeremy Jawish, CEO and co-founder of Shift Technology. “Gaining a more complete understanding of the forces impacting their business and the industry as a whole, and to do so quickly and efficiently, is an amazing value proposition and a new way to harness the power of shared data.”
Taking an even deeper view of the given proposition, we begin from the IDN’s promise to provide accurate data-driven insights. With detailed data mapping and AI-powered entity resolution across carriers, IDN is able to generate highly accurate insights and recommendations. Once generated, these insights are automatically integrated into the insurer’s workflows and user interfaces.
We referred to IDN’s bid to provide you with actionable claim history intelligence, but what we haven’t yet touched upon is how insurers can also define and configure the relevance threshold for receiving loss history insights and information.
Beyond that, there is the potential for proactive automation, context and explainability. This translates to how IDN proactively and automatically transforms data into actionable insights before delivering findings directly to users.
This goal here is to eliminate the need for manual search, matching, and analysis, instead streamlining the claims process and enhancing efficiency.
“The insurance industry has long known that data, and the insights it can provide, are highly valuable and critical to long-term success,” said Jawish. “With the launch of IDN, insurers are changing the way they benefit from their own data. The ability to use shared data in new ways, to gain greater understanding of what’s happening across the industry.”
