The fraud detection tools in the market typically work by flagging cases as ‘Red’, ‘Amber’ or ‘Green’ – but crucially don’t explain why something may be fraudulent.
The heavy lifting (the bit that requires the time and effort) is presently undertaken solely by experienced fraud handlers who manually review the claims documentation without any assistance.
Clyde and Co are using advanced AI and automation to provide a system that not only automatically reviews and flags the claims as fraudulent, but also analyses the evidence and suggests what parts of a particular case are suspicious and why they might be suspicious.
The tool produces a full report with fraud markers weighed and measured to save handler time and effort – making it truly unique.
Learning Objectives
At the end of this session, delegates will be able to:
- Describe the benefits of the AI in the use of automation and fraud detection, which includes:
- Listing suspicious opponents
- Summarising your risk exposure
- Explaining effective risk management strategies which could be put in place
About the Presenters
Damian Rourke (Partner)
Damian advises on fraud risk and strategy in all types of civil/criminal fraud cases, including motor, personal and commercial property, employers’ and public liability, personal accident cover and professional liability.
His work ranges from single policyholder frauds to complex, highly organised cross-insurer fraud rings.
He acts for a range of professional clients, from household name insurers, retailers and large-scale fleets to local authorities and self-insured publicly listed and private companies.
Damian contributes to industry debate and awareness through regular public speaking, workshops, published articles and involvement with industry groups; including being a member of the FOIL SFT.
He is responsible for the day-to-day management of various insurer client accounts, managing a dedicated team based in the Manchester office.
Damian is an experienced litigator and has advised various insurers with drafting of precedent repudiation documents for claims pre-issue and assisted in setting up/implementing initial claims validation strategies including KFI checklists.
Ben Parsons (Head of Digital)
Ben is the Head of Digital for our Casualty Practice, based in Manchester. His role is to work with partners and clients to deliver digital innovations for our clients and technology platforms to improve our ways of working.
He is responsible for our Casualty Innovation, Automation and Digital Transformation workstreams, focused on transforming the way in which we work for and with our clients. Ben is designing our next generation of products to help address the challenges our clients face in personal injury claims handling whilst also automating our internal claims handling processes.
