SYSTEM AND METHOD FOR MONITORING INSURANCE CLAIMS AND DETECTING FRAUD AND COMMUNICATION THEREOF

摘要

A computer-implemented method of verifying claim data comprising receiving the claim data having a claim associated therewith from a data source, analyzing the claim to assess the accuracy thereof, sending a verification request to an insured associated with the claim requesting that the insured verify the accuracy of selected portions of the claim, receiving verification information from the insured in response to the verification request, and then programmatically assessing the verification information from the insured. If the insured verifies the accuracy of the selected portions of the claim, programmatically updating a profile associated with the insured to include the verification information, and then programmatically sending authorization instructions regarding payment of the claim. If the insured does not verify the accuracy one or more portions of the selected portions of the claim, then programmatically initiating a fraud investigation of the portions of the claim that are inaccurate.