Analyze a Claim

To analyze a claim for potential fraud, click on the Process Claim link on the top navigation bar. You will then be asked to select the type (fraud class) of the claim and to enter a claim identification code to track your claim for the duration of the analysis.

For each indicator select Yes, No, Unknown or Not Applicable. If the indicator needs follow up you may remind yourself of this fact by checking the Follow Up box.

You may add annotations to document your decisions or investigations per indicator by clicking on the graphic. The double paperclip graphic means an annotation has been entered. You may add an unlimited number of annotations.

When a claim is closed the final outcome should be recorded by clicking on the Process Case link and entering the claim ID and selecting the appropriate outcome from the list of choices given.

Notification E-mails

To specify notification e-mails in the event that SAFEST indicates that a claim should be investigated for fraud click on the Management-Console link on the navigation bar. Generally notification e-mails would be sent to the Special Investigative Unit (SIU). For each claim you can specify which contacts should be notified and add a short note. The text of each of the selected fraud indicators are included in each e-mail notification sent out.

Closing your Session

When you are done with your case, click on the Logout link on the top navigation bar. In the event you fail to logout your session will expire in 30 minutes.

Reports

A wide variety of summary reports are available from the Management-Console.

Advanced Features for Administrators

If you have an Administrator user account you can add new users and edit and delete existing users from the Management-Console.

Each claim processed is assigned points according to the number and type of indicators selected. When the point total reaches a certain threshold SAFEST recommends the claim be investigated. The point thresholds for each class of fraud can be adjusted from the Management-Console by clicking on the Knowledgebase link. Charts, tables and statistical results are available to help determine the optimal threshold.