claims_processing · finance · workflow
Pan-Asian insurer uses Shift Technology Force to identify 80% more fraud cases in real-time
A rapidly growing multi-line pan-Asian insurance company was experiencing increasing fraud, waste and abuse across its claims portfolio, with the vast majority of suspicious cases going undetected before claim settlement.
How it works
Common implementation structure
How this type of workflow is generally built, generalized across documented cases — not tied to any one vendor's stack. Click any stage to read what happens there. Specific products that implement these stages appear in “Tools commonly seen” below.
Stage 1 · Claims submitted for processing
Over 500,000 claims are processed annually, initiating the fraud review pipeline.
Tools used
Force
Outcome
Force enabled real-time fraud identification prior to claim settlement, with the insurer reporting that 80% of suspicious cases would previously have gone undiscovered, yielding considerable savings and increased straight-through processing.
Results
Volumeover 500,000
Cost replaced80%
Grounding & classification
Source type: vendor customer story
18 fields verified against source quotes.
anomaly detectionfraud detectioninsurance claimmetric backedproduction runtime claimedtools describedvendor confirmedworkflow describedinsuranceaccuracy improvementautomation ratecost reductionvendor customer storyclaims processingmonitor detect alert