How does the fraud funnel work?

LISA Claims delivers a fraud scoring where the following stages are analyzed through a funnel.

  • Fingerprint analysis of the insured’s email (determines whether this is a disposable email or not).
  • Documentary Analysis (documents that have been adulterated can be detected).
  • Video Story (The emotion of the insured is analyzed).
  • Static database (blacklists managed by the company).
  • Ecosystem database (Companies that wish to contribute to this collection of anonymized information will be able to detect fraudulent claims).

With all this information, LISA Claims will be able to provide a scoring that reflects the probability that the claim is fraudulent. Throughout this process, our platform will be able to appeal to the claimant to desist from the process if it detects a possible fraud.

How does the data capture at the tip and its automatic processing work?

Our AI captures data based on training according to cells/keys that correspond to words/fields.

Is it possible to export regulatory information from the platform?

Yes, it is possible. LISA Claims can output the company’s historical information, which can be used to display the regulatory claims folder, among other things.

What does the duration of the implementation or set-up process depend on?

It depends on the training of the reading models of our AI technology. In addition, the branches and coverages to be included in the implementation must be considered.

What is the technological architecture of LISA Claims like?

LISA Claims is a proprietary technology in the cloud and agnostic to the information system. It also has a micro-services architecture, making it agile for any type of integration through APIs and web services.

Who owns the information stored in LISA?

The information will always remain the property of the insurance company.

Does LISA Claims take care of the payment?

LISA Claims is able to connect to different payment gateways, such as VISA Direct, of which it is a partner. In other cases, it can issue the list of claims to be paid, which is managed by the company’s payment area. Likewise, LISA Claims can also export a payroll base of claims, to be managed by the company’s payment area.

What happens if there is pending documentation from the insured?

LISA Claims will notify the insured and the insured will be able to upload it to the platform.

What happens with the claim provisioning?

When the claim is entered into LISA Claims, the claim provision is generated in the company’s core system. Once the report is made, LISA updates the actual provision.

How can a claim entry be made in LISA Claims?

Claim entry can be done manually and in bulk by uploading an XSL document in LISA Claims.

Likewise, the claim can be made by filling out forms, using the company’s Whatsapp and on the LISA Claims platform.