Wyo. Workers’ Safety and Compensation Division Chooses Fair Isaac Program for Early Detection of Fraudulent Claims

Fair Isaac Corporation, a provider of analytics and decision technology, announced that the Wyoming Workers’ Safety and Compensation Division (WSCD) has implemented VeriComp Fraud Manager to enhance its workers’ compensation fraud detection capabilities.

VeriComp Fraud Manager will enable WSCD to detect fraud and abuse much earlier and more accurately in its claims review process, reportedly resulting in reduced claims losses and a streamlined payment decision process.

As the exclusive workers’ comp insurer in Wyoming, effectively fighting fraud and abuse is a major priority for WSCD. VeriComp Fraud Manager scores claims on the likelihood of fraud and abuse, lowering costs by helping claims adjusters identify potentially fraudulent or abusive claims early, and allowing them to focus only on claims requiring their scrutiny. Using Fair Isaac’s advanced predictive analytics, VeriComp Fraud Manager can recognize abnormal patterns that even the most experienced adjuster might miss.

“Finding fraud and abuse early is critical to containing costs for our insureds,” said Gary Child, administrator of the Wyoming Workers’ Safety and Compensation Division. “We believe that VeriComp Fraud Manager will dramatically improve our ability to discover fraud and abuse and help keep the cost of workers’ compensation claims as low as possible. By utilizing VeriComp and its Industry Alliance data pool, we feel confident that we will be more productive and more accurate in assessing which claims should be investigated for fraud and abuse.”

In addition to a new Web-based Application Service Provider (ASP) delivery method, VeriComp Fraud Manager is available using an Industry Alliance database, which offers insurance payers the advantage of predictive models built with millions of industry claims.

While pooling fraud data in an Industry Alliance has been common in the financial services industry, the Fair Isaac Industry Alliance is reportedly the first offering of its kind for the workers’ comp industry. Comparing claims against a large pool of industry data helps assure that claims are scored more accurately.