Use predictive analytics to help you minimize costs while improving your claim-handling process
Claims management costs comprise a significant amount of some insurance companies’ operational expenses, encompassing up to as much as 20%. Considering that the claims process directly affects customer satisfaction, claims management is one of the most critical functions of your business. Reducing claims management costs, even by a small amount, can have a significant, positive impact on your company’s performance.
Using a combination of rules, modelling, text mining, database searches and exception reporting to identify fraud sooner and more effectively at each stage of the claims cycle.
Primary Claims Management Solutions
Version 1’s SPSS experts can consult and deliver a wide variety of Claims Management solutions. Read more within the sections below.
Claim fraud is increasing and the focus on claim fraud is increasing as well. 1 out of 10 insurance claims is fraudulent. How do you spot those before a hefty payout is made? Most fraud solutions on the market today are rules-based.
Unfortunately, it is too easy for fraudsters to manipulate and get around the rules. Predictive Analytics, on the other hand, uses a combination of rules, modelling, text mining, database searches and exception reporting to identify fraud sooner and more effectively at each stage of the claims cycle.
Combine risk profiles with business rules to resolve legitimate claims in as little as one phone call.
Streamline claims processes and decision-making, and implement continuous process improvement.
Make better use of skilled investigators by enabling your staff to focus only on complex claims or high-value suspicious claims.
Minimise claim payments and reduce fraud with real-time alerts of suspicious activity.
Improve customer service and keep costs down by streamlining the claim handling process; for example, industry studies show that fast-tracking legitimate claims reduces customer frustration and minimises the likelihood that policyholders will take negative action.
Decrease the amount of time it takes to process a claim by several days on average by improving claims routing, providing adjusters with suggested tasks and real-time assessment of adjuster statistics.
Build and use methods for scoring claims particular to state differences, lines of business, or times of catastrophe.
Improve subrogation results by focusing on the claims more likely to pay you back.
“Choosing SPSS Statistics Base and SPSS Modeler has been very advantageous. Proof lies in the results achieved and the fact that we rely so much on the tools. We will continue to seek other SPSS Inc. tools that will help us gain competitive advantage.”
“With predictive analytics, we were basically able to close a hole in our pocket where money was leaking out steadily. We were also ready to show that this was just the beginning.”
“IBM SPSS predictive analytics software has given us the means to learn systematically from our experience. By learning from the history, we can know today who will buy a given product in the future.”
“Analytics gives us a method of assessing impact of factors that we may not be able to measure directly – so that we can do more with the data we already have, instead of making big investments in high-tech equipment.”
“Course was excellently presented with a clear overview of research and statistics principles and the IBM SPSS Statistics software package. I found it challenging but very informative and a useful introduction to IBM SPSS Statistics.”
Claims Management Case Studies
Case Study – Insurance Bureau of Canada
The insurance industry is constrained by the manual and ad hoc approach to detecting and investigating potential fraud. To address its objective of automating the detection of potential claim fraud and the identification of possible fraud rings, IBC engaged IBM to perform a Proof-of-Concept project using IBM® InfoSphere® Identity Insight and IBM SPSS® Modeler. The benefit IBM POC quickly found suspects and their claims reducing investigation efforts; found a previously unidentified suspect fraud ring; and gathered more information against suspected fraudsters with a higher degree of confidence.
Related resources from our Learning Hub
SPSS Webinar – Hot Tech Tips for Using SPSS Statistics Part 2
In part of this webinar on Hot Tech Tips for using SPSS Statistics, our Data Analytics consultant will take you through Custom Tables, Linear Regression, Logistic Regression and options for Survival Analysis in IBM SPSS Statistics. Download to learn more.
IBM SPSS Whitepaper – Customer Analytics in Banking
In this white paper, you will learn how your organisation can use customer analytics to understand what customers want and will do next, along with the key capabilities required to effectively conduct customer analytics. Download to find out more.
IBM SPSS Whitepaper – Predictive Analytics Solutions for Education
Download the IBM SPSS Whitepaper Predictive Analytics Solutions for Education to learn more.
What’s New in IBM SPSS Statistics v29?
Looking to quickly learn what’s new in IBM SPSS Statistics 29? Rather than reading a list of changes and new procedures, there is a quick way to tour what’s new and access help. Read our post for more info.
Tech Tips – Count Occurrences within Cases
We have a wide variety of Tech Tips for IBM SPSS created by our SPSS experts. This Tech Tip will help you count occurrences within cases in IBM SPSS Statistics.
Tech Tips – Annotating Nodes in IBM SPSS Modeler
We have a wide variety of Tech Tips for IBM SPSS created by our SPSS experts. This Tech Tip will help you annotate nodes in IBM SPSS Modeler.
Tech Tips – Accessing Help from Output in IBM SPSS Statistics
We have a wide variety of Tech Tips for IBM SPSS created by our SPSS experts. This Tech Tip will help you access Help from Output in IBM SPSS Statistics.
Tutorial – Getting Started with Custom Tables in SPSS Statistics
In this video, the first in our Custom Tables for SPSS Statistics series, our SPSS expert will help you get started with Custom Tables in SPSS Statistics. Presented by our SPSS Data Analyst, this is the first of four videos in the series covering SPSS Custom Tables.
IBM SPSS Whitepaper – Analytics: Real-world use of Big Data in Telecoms
Download the IBM SPSS Whitepaper Analytics: Real-world use of Big Data in Telecoms to learn more.
Tutorial – Running Chi Square Tests in Custom Tables in SPSS Statistics
In this short video, the second in our Custom Tables for SPSS Statistics series, our SPSS expert will help you run Chi Square Tests in Custom Tables for SPSS Statistics.This tutorial will include highlighting significant results, hiding cells with low counts and running multiple chi-square tests within the same table.
Tech Tips – Customising Toolbars
We have a wide variety of Tech Tips for IBM SPSS created by our SPSS experts. This Tech Tip will help you customise toolbars IBM SPSS Statistics.
What’s New in SPSS Statistics v27?
SPSS Statistics v27 was launched in June 2020 with the biggest change compared to v26 being the inclusion of Data Preparation and Bootstrapping as standard functionality, as part of the SPSS Base module. This post will take a high-level look at these changes plus cover off the key enhancements in v27.
Tutorial – Running T-Tests & Building Bar Charts in SPSS Statistics
In this short video, the third in our Custom Tables for SPSS Statistics series, our SPSS expert will focus on running T-tests and building bar charts in custom tables. At the end of this short tutorial, you should be able to conduct a comparison of column means and generate graphs to build better and more visual output.
IBM SPSS Whitepaper – Improving Claims Management Outcomes with Predictive Analytics
Claims management professionals have to deal daily with formidable, and sometimes competing, challenges. Predictive analytics can help overcome the challenges encountered by Insurers. Download the whitepaper.
Industry-Leading Support to Make the Most of Your Advanced Analytics Software
Our Documentation & Support section provides 24/7 access to online fault logging as well as support documentation and FAQs.
Log A Support Ticket
Discover More Industry-Specific Solutions
Version 1’s SPSS experts can consult and deliver a wide variety of analytics solutions across a broad range of industry sectors. Find out more at the links below.