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Shift Technology

AI platform for insurance decisions with fraud detection and claims automation
Finance
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Shift Technology

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Shift Technology
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EN
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AI TEHNOLOGIES
Description

Shift Technology delivers a comprehensive AI platform specifically designed for the global insurance industry. The platform combines generative, agentic, and predictive AI capabilities to transform how insurers make critical decisions across underwriting, claims, fraud detection, and compliance operations.

The platform addresses the growing complexity and risk facing modern insurers by providing intelligent solutions for multiple insurance domains. For underwriting risk, Shift detects policy fraud and mitigates premium leakage to improve accuracy and efficiency. The claims fraud detection solution identifies fraudulent activities with speed and accuracy, managing case investigations and leveraging the Insurance Data Network to uncover patterns across carriers in real time. Payment integrity solutions ensure healthcare payment accuracy and maximize savings, while the subrogation module uses generative AI to accurately estimate liability and avoid missed recovery opportunities.

Shift's agentic AI capabilities transform claims processing by handling both simple and complex claims for more accurate and efficient experiences. The compliance risk solution supports anti-money laundering, know-your-customer requirements, and risk management with AI assistance. The platform delivers extreme accuracy that exceeds human performance while maintaining complete explainability, ensuring every decision includes transparent reasoning.

The technology enables rapid deployment and easy integration, using historical data in any format without extensive preparation. Shift maintains the largest data science team globally focused exclusively on insurance AI applications, with over 200 specialized professionals. This deep expertise translates into solutions built around real insurance industry needs, incorporating external data integrations including geo-location, images, weather databases, and sophisticated relationship analysis to detect complex fraud schemes.

The Insurance Data Network provides insurers with industry-wide perspective and cross-carrier insights, enabling proactive detection of sophisticated fraud patterns. Advanced entity resolution and document analysis powered by generative AI help decode complex schemes and expose fraud connections across providers, networks, and claims. The platform automatically investigates risks using advanced AI to identify and surface threats earlier in the claims lifecycle, helping prevent fraudulent payouts before they occur.

Shift equips insurance teams with intuitive case management tools, automated data surfacing, and streamlined workflows designed for speed and collaboration. By automating routine tasks, the platform accelerates case resolutions while reducing delays, eliminating bottlenecks, and minimizing administrative overhead. The solutions have helped customers validate more claims than ever before, with documented cases of stopping $12 million in fraud and reducing processing times significantly.

Use cases
  • Detect policy fraud at underwriting stage to prevent premium leakage and improve risk assessment accuracy
  • Identify suspicious claims activities in real time at first notice of loss and throughout claims lifecycle
  • Investigate healthcare payment accuracy to maximize savings and ensure proper billing compliance
  • Estimate subrogation liability with generative AI to capture recovery opportunities across claim portfolios
  • Automate claims processing with agentic AI for faster resolution of both simple and complex cases
  • Support anti-money laundering and know-your-customer compliance requirements with AI-powered risk analysis
  • Leverage Insurance Data Network to detect fraud patterns and connections across multiple insurance carriers
  • Analyze complex fraud schemes through entity resolution, document analysis, and network relationship mapping
  • Streamline special investigation unit workflows with intuitive case management and automated data surfacing
  • Monitor compliance risks across insurance operations with real-time alerts and intelligent pattern detection
  • Integrate external data sources including geo-location, images, and weather databases for enriched investigations
  • Prioritize high-ROI fraud cases to focus investigative resources on most impactful threats
Features
Fraud Detection, Claims Automation, Underwriting Risk Analysis, Payment Integrity Verification, Subrogation Management, Compliance Risk Monitoring, Insurance Data Network, Entity Resolution, Document Analysis, Case Management Tools

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