INFORM and Zurich Mexico Address Insurance Fraud, Automated Claims Handling and Medical Billing Fraud Together

Zurich Mexico optimizes its claims evaluation process and reduces losses caused by insurance fraud with RiskShield by INFORM

A relationship that began six years ago has been renewed and expanded within the Mexican market through Zurich Mexico. The insurance group offers personalized prevention and protection solutions, adapting global services to fit specific client needs in the region. Zurich Mexico reconfirmed the trust it places in RiskShield to combat insurance fraud and automate its claims handling process. RiskShield is currently being implemented in both the motor and property lines of business and is set to be expanded into the medical billing space in the coming months.

"RiskShield's real-time capabilities allow us to react flexibly within the claims handling process. Claims agents are provided with alerts when follow-up questions need to be asked, enabling them to obtain additional information important for the claim," states Ricardo Fu, Regional Chief Claims Officer at Zurich in Latin America.

Ricardo adds, "Our entire workflow is optimized using RiskShield, from claims reporting to investigations of suspicious claims. Regarding our motor line of business, RiskShield allows for the enhancement of fast-track claims processing. We are also set to expand the use of RiskShield to include automatic payments management and to provide additional information to on-site adjusters. We have experienced a substantial increase in the detection rate of fraudulent cases in our motor line of business over the past 12 months because of the joint effort with INFORM."

INFORM and Zurich Mexico will be addressing the recent spike in healthcare fraud, specifically in the field of Telemedicine, using RiskShield's intelligent fraud detection platform. "Our current focus is on implementing this state-of-the-art technology within our medical billing line of business," concludes Ricardo.

Roy Prayikulam, Senior Vice President Risk and Fraud at INFORM states, "We are very much looking forward to expanding our relationship with Zurich Mexico. Our continued partnership is a testament to the work we are accomplishing together in the fight against fraud. The entire insurance industry has been thrust into the world of digitalization due to the current pandemic and we are happy to be supporting Zurich Mexico along this journey."

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About Zurich Mexico

Zurich Mexico started its operation in Mexico City in 1984 with a representative office. Since then, we differentiate ourselves in the market for the value we create for our clients. We provide risk prevention and protection solutions in the General Insurance and Life Insurance segment in strategic points of the country, always being close to our clients. In Zurich we have an important risk engineering practice, and we are key partners in the underwriting process, that is, in how we make the selection and listing of risks for companies and, where appropriate, the renewal of their accounts when they already have insurance that protects your operation. We bring the benefits of a risk prevention culture closer to our clients. For more information about Zurich Mexico visit: www.zurich.com.mx