AI-powered claim fraud defense: trusted by global insurers

There has been a surge in insured opportunists falsifying digital documents in an attempt to defraud their insurer. Trusted by global insurers, Qualitest’s AI-powered solution prevents fraudulent claims from slipping through. It accurately detects manipulations made to documents, and promptly alerts insurers about changes in digital documents, duplicates, and more. This provides a vigorous claim fraud defense.
Your Benefits

Stay one step ahead of insurance claim fraud

It has become standard for insurance customers to expect insurers to underwrite more risks, in more and more varied policy types, with the speed and ease of digital document management. Meanwhile, sophisticated fraud techniques, data breaches and third-party leaks of personal information to the dark web have all given fraudsters more opportunity to submit spurious claims. This is where Qualitest’s AI fraud detection solution comes in.

  • Use AI to detect 15 – 25% more claims fraud in your digital documents and trigger real-time alerts.

  • Rapidly compare documents to uncover claim duplication.

  • Automatically detect normal usage patterns and identify anomalies through machine learning.

  • Save valuable time on unnecessary investigations; our solution does this outstandingly well for you.

  • Reduce damages and loss by preemptively capturing fraudulent claims.

Revolutionize your claims data processing with the power of AI

With powerful AI capabilities embedded in your document verification and fraud detection, you instantly gain next-gen efficiency in your claims handling. Qualitest AI fraud detection solution scans every last document and significantly increases digital claims fraud detection by 15 – 25%. With the help of Qualitest’s AI fraud detection solution, you can:

Mitigate claim fraud risk

Leverage cutting-edge AI to ensure your organization has maximized efforts to minimize the risk of claim fraud.

Tailor your detection strategy

Claims evidence comes in different forms. Every inbound form, check, opinion, and summary of a medical visit looks different. Our AI solution learns all possible patterns, identifying both content, text, and visual details.

Achieve order and transparency

Every day, thousands of documents flow through your systems. With our solution’s practical dashboard, you can organize and monitor every stage, seeing how many documents are scanned, and identifying those that are clean, suspicious, or flagged as potentially fraudulent.

Unlock peak efficiency

Measure system efficiency with clear metrics. Gain a significant increase in the detection rates, reduced fraudulent costs and damages, and save the time of your signing and investigation teams for true efficiency and coverage.

mitigate claim fraud risk
tailor your claim fraud detection strategy
achieve claims handling order and transparency
unlock peak efficiency
Our Solutions

A next-gen weapon in your fight against fraud

Insurance fraud impacts millions of customers, leading to higher premiums and harming the general population. In the age of deepfakes, you need an effective solution to this major problem.

Qualitest’s fraud detection solution is an advanced AI tool to significantly reduce fraud cases, enabling you to offer more cost-effective services to your customers. It enables you to:

Identify duplicates

Ensure complete confidence in your claims process by comparing every registered document to historical records, effectively preventing fraud through duplicated claims.

Detect manipulation

Effortlessly detect and stop malicious document alterations and unjustified claims with our quick and precise manipulation detection capabilities.

Detect anomalies

Harness the power of our advanced AI to analyze vast amounts of data, uncover hidden patterns, and distinguish ‘normal’ patterns in valid documents, significantly enhancing detection speed and efficiency.

Never repeat mistakes

Protect your system with proactive ‘watchdogs’ that learn from past positive cases and continuously monitor for similar fraudulent characteristics, ensuring breaches never recur.

Turn images into data

Transform scanned document content into actionable data, unlocking a new world of analytical insights, business intelligence, and enhanced operational capabilities.

Global FS and Reinsurance Leader

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Secures 40% Cost Efficiency with Expert Quality Engineered Managed Testing Services

01—Challenge

Quality and agility issues were hampering the Agile transformation the Client had embarked upon.

Incumbent suppliers had become too comfortable with the status quo to deliver dynamic solutions.

02—Solutions

Using AI tools, Qualitest devised a comprehensive Quality Engineering Strategy for present and future Business Assurance.

We laid out a roadmap to implement changes across culture, process and technology to mature their testing organization into a Quality Engineering function, building quality into every point in the product journey.

03—Results

2,000 hours saved by utilization improvements. 100% critical scenarios automated. 47% regression automation achieved (increased from <5% in three months).

Defect rejection rate reduced by 85%. Defect detection rate increased by 3.6x. Defect removal effectiveness increased to 98%.

Let us know how we can help you.

We’re ready to talk, how can we make your life easier?