SPSS Claims Management

Claims Management

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

    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.

  • Claims Processes

    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.

  • Suspicious Activity

    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.

  • Customer Service

    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.

  • Claim Scoring

    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.”

    Market Planning and Bundling Department VTR GlobalCom

    “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.”

    Bill Dibble Infinity Property & Casualty

    “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.”

    Ola Gistafsson Länsförsäkringar

    “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.”

    Matthiew Lirette-Gelinas IBM Bromont

    “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.”

    Paul Sheehan Cork Simon Community

    Claims Management Case Studies

    No Posts Found

    Related resources from our Learning Hub

    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.

    Support Documentation

    Support 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.

    Arrange a free consultation to discuss your analytical needs and identify the best solution for you.