| 摘要 |
Systems and methods for insurance claims processing in an insurance industry are described. The method comprises combining extracted claims data from one or more data sources to obtain a consolidated claims record and removing noise from text data of the consolidated claims record to obtain a claim dataset. The claims data comprises a plurality of claims. Further, ascertaining one or more suspicion indicators in the plurality of claims based on an analytical technique. Further, assigning a score to each of the plurality of claims based on at least one scoring rule. The score is an indicative of a level of suspicion of a claim. Furthermore, detecting at least one of insurance claims fraud and subrogation potential claims based on the score assigned to each of the plurality of claims.
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