Claims fraud detection

Assessing risk in order to reduce exposure by accurately identifying risks and automatically detect cases where further investigation is required at the claim stages of the insurance lifecycle.

What is insurance fraud

Insurance companies are exposed to organised and opportunistic fraud. There are 4 main categories of soft and hard insurance fraud:
- opportunistic fraud in general and retail insurance, which includes exaggerated and fabricated claims, and in commercial insurance where the focus is on organisations, rather than individuals, committing frauds.
- organised fraud involving gangs
- claims fraud is where an individual or organisation makes a fictitious or intentionally inflated insurance claim, for example someone claiming for non-existent jewellery or for a slip or trip which never took place
- application fraud is where an individual or organisation manipulates facts on their insurance application in order to lower their premium, for example someone falsely stating they have never made an insurance claim before.

Clearly, there is a significant difference between opportunistic fraud, where people encounter an opportunity within their everyday experiences to commit fraud and more organised planned frauds.
Fraud is also more common than people think, because we tend to refer to hard insurance fraud, which actually represents the minority of cases. Burning down a building or crashing a car on-purpose is what is called hard insurance fraud because the source of the claim was entirely manufactured. On the other hand, soft insurance fraud is far more common because it consists of inflating the value of a legitimate claim. This type of fraud takes up the majority of an insurance fraud investigators’ time.

A dynamic fraud detection approach

Reducing fraud losses is a high priority for all insurers, with the market recognising they must contain fraud as a ‘managed risk’.  There is no room for underestimating the fraudsters targeting the industry, who continually evolve their methodologies in direct response to insurers’ counter fraud strategies.  The opportunities afforded to fraudsters by new technologies are driving innovative techniques for perpetrating fraud over the internet. A dynamic counter fraud model is essential for insurers to protect their honest customers and bottom line.

Claims fraud indicators can be grouped into four main areas:

1. Expert Rules: drawn from the insurers’ claims expertise and based on the company’s internal data to identify typical fraud indicators eg. five or more people involved in an accident; a claim within 30 days of policy inception.
2. Geographical Rules: localising the individuals, the place and the entities involved in the claim and where possible integrating external geographical data to assess environmental risk.
3. Relational Rules & Link Analysis: risk assessment based on the relationships between the people involved in the claim and any links to previous suspicious claims history.
4. Analytics Rules: Data analysis using advanced statistics techniques and predictive models to identify representative behaviour of fraudulent claimants.

Improve your claims process thanks to data enrichment. Uncover information about any business and complement your claims verification.


Reports and Documents On Every Company, Director and Business In The UK And Across The Globe:

  • COMPANY REPORTS
    Outlining all statutory information filed by Irish and UK companies.
  • COMPANY DIRECTORS
    View current and past Directors, as well as any other companies the Directors are involved with.
  • COMPANY DOCUMENTS
    Access documents filed in the CRO in Ireland, Companies House in the UK and all International Registers
  • OWNERSHIP STRUCTURE
    Discover beneficial owners of companies and group tree structures.
  • MORTGAGES AND CHARGES
    View details of all mortgages and charges registered against a company's assets
  • MONITORING & ALERTS
    Monitor any Company or Director for new document filings or changes in status, risk level or judgments.

Find company information

CACHE PI

The CACHE PI service enables insurers to search the Claims and Underwriting Exchange Register Personal Injuries database (CUE Search) and obtain a full report of the personal injury claims history of a given individual. It holds over 13.4 million personal injury insurance claims.

CACHE Home

The CACHE Home service allows insurance companies to run a search in the the Claims and Underwriting Exchange Register Home database (CUE Search) and access a full report containing the home insurance claims history of a given individual. It holds over 6.6 million household insurance claims.

CACHE Motor

CACHE Motor service enables isurers to search the the Claims and Underwriting Exchange Register Motor database (CUE Search) and provides a comprehensive report of the motor claims history of a given individual. It holds over 18.5 million motor injury insurance claims.

CACHE Smart

As an additional module of CACHE, the CACHE Smart module allows insurers to enrich searches with linked addresses coming from a file of over 30 million records increasing the matching capability against the the Claims and Underwriting Exchange Register database (CUE), which can then be integrated with specific anti-fraud models. 

CACHE Plus

As an additional module of CACHE, in one call the CACHE Plus product combines information on motor and personal injury claims related to road traffic accidents (RTAs) allowing insurers to indentify and detect fraud. 

UK Business Information & Company Searches

Reports and documents on every Company, Director and Business in Ireland, and in the UK. Professionals looking for the highest quality company information can use CRIF solutions to help them achieve the best results in terms of profitability and healthy growth. CRIF has established a new approach to business information using a scenario where decisions and risks are based on a complex and robust framework of value-added information, dynamically updated and revised.

International Credit Reports across 230 territories

Wherever your goods are shipped or sold, you can now enjoy the latest details on over 200m companies across 230 territories. Credit reports, document and monitoring services to trade with confidence, visibility and transparency on worldwide relationships. Credit Reports are available online or can be freshly investigated, meaning that high quality information is guaranteed anywhere in the world.

CACHE Data Entry Assistant

CACHE PI – Data Entry Assistant (DEA) enables insurance companies to improve efficiency and reduce costs by fully automating the entry of personal injury claims into CACHE PI.

CACHE CRU Electronic Messaging

A unique workflow solution enabling insurers to electronically submit and receive messages to and from the Department for Works and Pensions (DWP). 

Customised Workflow Systems

Workflow systems are specifically developed to support insurance companies and government bodies in automating and streamlining processes, enabling clients to electronically submit and receive messages, saving time and cost, improving internal procedures and gaining a competitive advantage.