How To Find Fraud In Insurance Claims Verisk

According to the National Insurance Crime Bureau (NICB), insurance fraud is the second most costly white-collar crime in the United States, following tax evasion. Even if you haven’t suffered a direct loss, your insurance premiums may still go up because of hard and soft fraud. These crimes add up to nearly $30 billion a year for insurance companies. For insurers looking to stem the billion-dollar insurance claims fraud problem[1], early detection is key. But with caseloads rising and hundreds of thousands of adjusters retiring , it’s tough for claims staff to keep a watchful eye on suspicious behavior. Patterns and connections amongst claims may be harder to unveil without access to the bigger picture.

That’s why access to advanced tools and expansive data is so important. The answer is for insurers to look beyond their own data. Checking the full scope of claims information for matches is essential as a first step in insurance fraud detection. The industrywide claims data in ClaimSearch® provides access to billions of claims details from nearly 97 percent of the property/casualty industry. When the system matches an incoming claim, it can reveal that the damage you’re trying to claim is actually part of an earlier claim or series of exaggerated claims. With this database, claims handlers can also easily see red flags of potential fraud, such as prior SIU (Special Investigations Unit) activity.

When there’s reason to believe an insured loss is suspicious, it’s essential to have a 360-degree view of the claim. Clues to insurance fraud could lie in details about the insured, the property, body shops, and medical providers on the claim. When the SIU gets involved, investigators may want detailed vehicle data, medical records, social media posts, criminal records, and much more. In an auto theft claim, for example, investigators may wish to pull a report that shows geo-tagged, time-stamped license plate photos from around the country. These may reveal a supposedly stolen car is actually garaged at the claimant’s brother’s house. But gathering all these pieces of information can be an exhausting manual process.

Fortunately, ClaimSearch offers integrated access to the Decision Net® supplemental data portal. Decision Net gives adjusters and SIU investigators a single point of access to hundreds of reports for a full claims picture. When an organized insurance fraud network is revealed, it’s like seeing the strands of a spider web—far-reaching, plentiful, with multiple points of connection. But your claims office would likely see only one part of the bigger swindle because organized insurance fraud rings can sweep across regions and even state lines with schemes involving many insurance carriers. Insurance fraud rings are big business, and they can score millions of dollars in claims before they’re done. Rings are led by smart criminals who trade in staged car crashes, fake injuries, unscrupulous medical providers, on-the-take body shops, and crooked lawyers.

Being able to see that a fraud network is behind the suspicious claims in your book of business depends on having a broad view of claims beyond your own company. Insurers can turn to network analytic tools like NetMap® to reveal the hidden connections in fraud networks and stop the losses from them. Carpe Data folds its next-gen claims intelligence into Verisk’s ClaimSearch platform, a move that gives insurers instant access to its injury-claim fraud tools without wrestling with yet another integration queue. ClaimSearch already anchors a huge slice of the P&C claims ecosystem, so plugging Carpe Data straight into that workflow feels like a practical shortcut rather than another shiny vendor link. According to Beinsure analysts, the collaboration lets carriers pull Carpe Data’s Online Injury Alerts and Investigative Reports directly inside ClaimSearch, meaning adjusters don’t need to hop between siloed systems or beg IT for rushed... Max Drucker, Carpe Data’s CEO, says insurers have dealt with too many stitched-together tools for too long, and this setup finally lets claims teams get “all-signal, no-noise” insights without grinding through months of backend...

Short beat. Through our collaboration with Verisk, property & casualty claims professionals can more easily access and benefit from Carpe Data’s all-signal, no-noise insights. Innovative insurance solutions powered by advanced data analytics, technology, scientific research, and deep industry knowledge. Create innovative P&C insurance programs, streamline data reporting to regulators, and leverage analytics to assess and price risks with speed and precision. Refine life, annuity, and pension plans from the individual to the portfolio level, driving value across individual life and annuity lines. Improve combined ratios and unlock greater reinsurance profitability by managing your risk on global, commercial, and enterprise levels.

Compete in new markets with solutions for specialties such as professional liability, management liability, and crime and fidelity. Insurers can now access Carpe Data’s best-in-class claims fraud solutions using Verisk ClaimSearch, a leading claims intelligence network and fraud detection platform SANTA BARBARA, Calif.--(BUSINESS WIRE)-- Carpe Data, a leading provider of next-generation data solutions for the insurance industry, today announced a new collaboration with Verisk (Nasdaq: VRSK), a leading data analytics and technology provider to... Carpe Data’s injury claim insights are now available in Verisk’s ClaimSearch® platform, offering insurers instant access to Carpe Data’s time- and money-saving fraud detection tools, including Online Injury Alerts and Investigative Reports. “Many insurers struggle with a patchwork of siloed systems, leaving IT teams overextended with integration backlogs that can drag on for months. As the cornerstone of the claims ecosystem, Verisk’s ClaimSearch platform enables insurers to tap into innovative solutions like Carpe Data with speed and confidence,” explains Max Drucker, CEO of Carpe Data.

“Through our collaboration with Verisk, property & casualty claims professionals can more easily access and benefit from Carpe Data’s all-signal, no-noise insights.” Insurers using Verisk ClaimSearch can access Carpe Data’s Online Injury Alerts and Investigative Reports, which include benefits like: “External threats to insurance claims departments have never been more diverse or sophisticated, so we’re focused on helping to ensure our customers stay well ahead of emerging risks,” said Jeff Ryan, chief product officer,... “By integrating Carpe Data’s innovative solutions, we’re enhancing the ClaimSearch ecosystem by leveraging our collective strengths to better defend our joint customers.” Early detection is key to stunting the growth of a mounting insurance claims fraud problem. But with caseloads rising and the industry facing a talent crisis, how can we expect our adjusters to keep a watchful eye on suspicious behavior?

Swipe through for a few ways your claims staff can identify potential fraud ➡ #AntiFraudFebruary #insurancefraud #fraud #claims Insurance fraud costs U.S. consumers an estimated $308.6 bn every year, putting pressure on carriers to adopt more advanced detection systems. Verisk has teamed up with Legentic to address this problem, launching two fraud-focused tools on its ClaimSearch® platform. The new features allow insurers to track suspicious activity across digital marketplaces and recover stolen property after claims are paid. Users gain the ability to automate investigative workflows, monitor platforms around the clock, and improve claims processing with limited IT demands.

Legentic’s analytics technology, widely adopted by European insurers, will now scale across the U.S. market. The collaboration expands the reach of fraud prevention capabilities and speeds up asset recovery efforts for American carriers. Jeff Ryan, chief product officer of Anti-Fraud Analytics at Verisk, noted that fraud and theft schemes continue to grow in complexity. New capabilities help insurers detect fraudulent claims activity and streamline recovery of previously paid losses JERSEY CITY, N.J., August 21, 2025 – Verisk (Nasdaq: VRSK), a leading global data analytics and technology provider, today announced a strategic alliance with Legentic, a fraud and financial crime detection and prevention company,...

Now available for the first time in the U.S., Digital Commerce Detector can help insurers automate the identification of suspicious activity on online marketplaces tied to stolen or total loss assets. Additionally, Digital Asset Finder helps streamline insurers’ location and recovery efforts of legitimately stolen vehicles and property post claim-payout. With insurance fraud in the U.S. now costing consumers $308.6 billion annually, according to the Coalition Against Insurance Fraud, and as property and casualty (P/C) theft schemes evolve, insurers face mounting pressure to detect fraud activity earlier and recover assets... Traditional manual investigation and asset location methods are often too slow, resource-intensive and costly, placing a heavy burden on IT, claims and investigative teams. ClaimSearch, the world’s leading claims intelligence network and fraud detection platform, now offers access to Digital Commerce Detector and Digital Asset Finder, enabling insurers to:

“Insurance fraud and theft continue to grow in sophistication, and we’re committed to equipping the industry with cutting-edge tools to help minimize financial exposure and operational strain,” said Jeff Ryan, chief product officer, Anti-Fraud... “Through seamless integration with ClaimSearch, this launch delivers automated access to previously hard-to-find, critical data points. These insights help empower insurers to identify fraud earlier, recover assets faster and drive more efficient claim outcomes.”

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