Protection for Insurance Companies and Policyholders

When it comes to insurance, it is not just the policyholders who need protection. Insurers themselves, whether they are in the healthcare, life, auto, property and casualty, or specialty industry, are continuously at risk of customer identity fraud. Fraud will eventually trickle down to your bottom line resulting in higher premium costs for your business and ultimately your customers. It’s a lose -lose situation. So why not mitigate fraud from the start with identity verification at on-boarding.

IDMERIT offers identity verification solutions that will help your company minimize risk and reduce costs across the board. Our services will allow you to approve more applications and process claims quickly and with more confidence.

How Common and Costly is Enrollment Fraud?

Enrollment fraud is a type of insurance fraud that carries serious implications. Anecdotal information suggests enrollment fraud happens relatively infrequently, but the financial impact is much larger than for other types of fraud. This is because these schemes are typically organized with the intention of committing fraud repeatedly. Some feedback indicates up to 10% of claims spending comes from new enrollees, so it is critical that these new enrollees be verified. Enrollment fraud is found by examining the identities being enrolled.

How we Help Determine Enrollment Fraud

To determine if your insurance company is dealing with enrollment fraud, you must observe the identities signing up for your services. A best practice is to do this during the onboarding process. The questions to ask during customer enrollment include:

To determine if your insurance company is dealing with enrollment fraud, you must observe the identities signing up for your services. A best practice is to do this during the onboarding process. The questions to ask during customer enrollment include:

• Is this a real person?

• Does the Social Security Number match the individual applying?

• Does this individual live in the same state they are applying for benefits?

To answer these questions, robust identity verification tools should be used. These tools can provide the insight necessary to determine if an account applicant is real or not. Let’s look at potential red flags that signal possible fraud that can be identified by identity verification.

• Does this identity exist, or was it fabricated?

• Is the identity deceased?

• Does the person live in the state where they are applying for coverage?

• IP address.

• What was the location of the device used?

• Does the identification match the biometric check?

Crosscheck Identity Data with Outside Sources

For effective enrollment verification, insurance providers must compare identity data with data from other sources. The sources that are used for comparison must provide contact information for member and relatives and a way to flag individuals with higher risk. IDMERIT provides these types of comprehensive identity verification checks. Using our solutions, you can rest assured that the individuals onboarded to your platform are who they say they are.

Effective Identity solutions will also evaluate outside data sources that can supply:

• Updated contact information for members, as well as information on relatives.

• Fields in a database to flag individuals with known risks.

Stop Enrollment Fraud in its Tracks

The insurance industry is aware that claim-based enrollment fraud is a problem in the industry. Different insurance providers are working together to stop it. Enrollment fraud does not occur frequently compared to other types of fraud. Regardless, it usually has a larger financial impact than other fraud. This is because long term fraud is usually committed when enrollment fraud happens. In these cases, fraud is committed various times over the course of time rather than just once.

Make Sure Claims Are Not Fraudulent

Insurers have a vested interest in verifying that their clients are who they claim to be. Identity theft and identity fraud costs the insurance industry billions per year in extra expenses – which are then passed on to policyholders in the form of higher premiums. Fraudulent claims can be greatly reduced through more effective identity verification procedures.

Advanced Protection for All Types of Insurance

IDMERIT provides advanced age and identity verification, so you will know that a person is who they claim to be. We give you a quick and secure way to approve both current and potential clients. You will be able to authorize more applications or process guarantees faster and minimize your operational costs. Our solutions can be applied to all types of insurance, including healthcare, property, life, casualty and specialty.

Benefits & Outcomes

• Streamlined Process: Our solutions give you a secure and quick way to approve both current and potential clients.

• Advanced Rules-Based Technology: Our platform allows you to perform age and identity verifications based upon the rules you define.

• Identify Genuine Clients: Quickly and easily distinguish between real and fraudulent policyholders.

• Save Time: With our streamlined process, you can approve more insurance applications in less time.

• Better Claims Processing: Properly identify clients so you can process claims more effectively and efficiently.

• Protect Business from Fraud: IDMERIT protects you from fraudulent claims – and your customers from higher premiums.

• Non-Intrusive Approach: Uphold your clients’ privacy and security transparently and seamlessly.

• Progressive Design and Control: We give you full control on how to handle ID verification.

Explore Our Solutions 

Our identity solutions for insurance fraud consist of three components:

• An overall risk score that indicates how much of the submitted information was verified.

• Risk indicators that spell out why submitted data may carry risk.

• Demographic updates such as new or additional phone numbers, alternate or prior addresses and alternate last names associated with the identity.

IDMverify is a proprietary product that offers quick and efficient identity verification. It is an API that takes identity data imputed into a system and crosschecks it against data from official data sources. By analyzing this data, it allows you to know your customer better. This solution is available for personal identity verification and business verification as well.

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IDMvalidate is an ID scanning technology that can validate if an identity document—national ID, passport or driver’s license—is real or not. From there it can extract the data found on the identity document and run it through IDMverify for validation. It also has a biometric liveness detection feature which helps determine if the user matches the identity on the imputed ID. All this information is compiled to deliver a confidence score about a person’s identity.

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IDMrisk is a device analytics tool. It validates user identities without the use of personal information. IDMrisk uses device information to determine if a user is legitimate or not. Different factors such as screen size, IP address, and device type, for example, help with the decision-making process. Fraudsters typically use specific technologies and techniques to manipulate secure systems. IDMrisk can identify these techniques and, if needed, stop a questionable user in their tracks.

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