Cogitate CFNA combines ultra-modern technologies to help a claims team identify potentially fraudulent claims as they are reported. Using the claim information, Cogitate CFNA generates a fraud network map, including various parties (individuals and service providers) that may be involved in possible fraud. It also provides a fraud probability score along with supporting fact-based evidence, which help determine further actions to prevent substantial losses caused due to a delay in fraud detection or fraudulent claims not being detected at all.
Cogitate CFNA uses artificial-intelligence-based complex algorithms and neural networks to identify fraudulent claims, based on the information provided in a claim. Scoring algorithms of CFNA use historical and other claims data to generate the fraud probability score of a claim and predict probability of fraud. Machine learning and deep learning models allow CFNA to learn new patterns of fraud and protect against future risks.
“Several of our friends in the business use the Cogitate solution. They highly recommended Cogitate for their industry expertise, solution capabilities and their friendly team who work with the customer to solve their issues. Our new claims system engages users throughout the claim lifecycle. It is helping our team to reinvigorate claims processes to improve customer experience, increase efficiency, and reduce operational cost. It is pre-integrated with various third-party data services and also with our other internal systems for real-time exchange of information.
“Cogitate Demand Management solution has so many features and benefits. We have significantly enhanced control over attorney demand claims exposure with this software. Demand Management solution helps us to ensure that no demand or a subsequent deadline is missed which can lead to bad faith. This is truly ‘sleep insurance’ for me when it comes to attorney demand letters. It’s an incredibly valuable tool for me as the Claims Vice President.”
The most crucial aspect of fighting claims fraud is early detection. With the automated backend processing of Cogitate CFNA, fraud probability scores and network graphs are generated at the First Notice of Loss (FNOL) stage. The intelligent engine of CFNA constantly keeps analyzing new information throughout the claims life cycle and keeps the scores and the network graph updated. This ensures extremely fast detection of fraudulent claims and close scrutiny at every stage.
Faster settlement of claims ensures enhanced customer satisfaction. Cogitate CFNA assists in segregating fraudulent and non-fraudulent claims, which is crucial to help adjusters settle non-fraudulent claims faster and refer the fraudulent claims to the Special Investigation Unit (SIU) at a very early stage. This approach helps in streamlining operations and improving the overall cycle time for claims settlement, thereby realizing significant savings in operational costs.
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