CHAPTER 01 · PAGE 4Northwind
Leakage becomes a data problem.
Most leakage is not fraud. It is ordinary claims paid a little too much, too often, because the facts sit in three systems.
Carriers that join claims, policy and payment data find two-thirds of their leakage within a quarter.
EXHIBIT 1.2 · WHERE LEAKAGE COMES FROM, POINTS OF COMBINED RATIO
Overpayment0.9
Missed subrogation0.6
Fraud0.4
Duplicate payments0.2
Total2.1 pts
“The money is already in your data. It just isn’t joined up.”
CLAIMS IN 202704
CHAPTER 05 · PAGE 27Northwind
What to fund in the next 12 months.
EXHIBIT 5.1 · CLAIMS INVESTMENTS, BY VALUE AND EFFORT
01Join claims, policy and payment data first.
02Put analytics on leakage before AI on adjusters.
03Leave core replacement until the data is clean.
CLAIMS IN 202727
