Case Study

Case Study:
Erie Insurance

Erie Insurance Improves Its Detection Process and Stays True to Its Values with LexisNexis® FraudFocus Enhanced

Erie Insurance Improves Its Detection Process and Stays True to Its Values with LexisNexis® FraudFocus Enhanced

FraudFocus Enhanced not only provides alerts to possible fraud, but it also helps adjusters at Erie Insurance "understand what the depth of investigation should be." It also facilitates efficient workflow and optimizes resources by allowing sound prioritization to be made so adjusters can know they are "looking at the right claims." Download Full Case Study

Summary

Erie Insurance offers auto, home, business and life insurance through a network of 2100 agencies in 11 states and the District of Columbia. One of Erie's founding goals is to deliver the highest levels of protection and service at the lowest possible price. One strategy toward meeting that goal is use of superior fraud detection tools from LexisNexis®.

Products Used

FraudFocus®
Detect possible fraud at the earliest possible moment

Challenge

  • Insurance industry studies indicate that 10 percent or more of property/casualty
  • insurance claims are fraudulent.
  • Fraud is the second most costly white-collar crime in America behind tax evasion.
  • Insurance fraud costs Americans billions of dollars each year.

Solution

  • Leverage FraudFocus Enhanced, which incorporates data, linking technology and analytics to provide intelligent information throughout the life of a claim, with the aim of delivering optimal fraud detection.
  • Receive an appropriate number of alerts, or notifying events, to make efficient use of both data and time.
  • Employ customer-specific customization that takes into account factors such as Erie’s underwriting portfolio and tolerance for risk.

Results

  • The predictive analytics that drive FraudFocus Enhanced serve to "level the playing field for adjusters in the review of claims and pursuit of fraud," according to Erie.
  • Claims of all sizes and types are subjected to the same treatment, which keeps smaller, more routine cases from being overlooked or given less scrutiny than larger, more complex claims.
  • Intelligent use of information and predictive analytics means "fairness across the board" at Erie, while providing a sound foundation for investigation and pursuit of fraud.
  • Claims that may be fraudulent get a second look.
  • Adjusters can know they are "looking at the right claims" with sound prioritization, facilitating efficient workflow and optimized resources.
  • Early identification reduces the instances of paid claims that are later found to be fraudulent, a situation in which the money is recovered only 3 percent of the time, according to Erie.
  • Through testing, Erie has determined that cases flagged by FraudFocus Enhanced have had the most return on its fraud investigation rate.

Next Steps

To learn more about LexisNexis® FraudFocus Enhanced or to receive pricing information, please call us at 866.828.0265 or fill out our simple online form.