From digging around, this seems kind of a new trend. I seriously doubt that "every claim at any insurance company" is being analyzed this way. And, sure, it's possible it was in use at the company where I worked and I simply did not know. But from reading some of what you linked to, I doubt it. (Though perhaps that has changed since I left.)

From one of the sites you linked to:

"Industry research indicates 10 percent of all claims contain an element of fraud," says Wolfe, and as of the end of 2010, CNA was seeing just 3.7 percent of its claims referred as potential fraud. "That’s considerably below the industry average, and we wanted to find out how much we were missing that wasn’t identified by our adjustors."

So, yeah, that's relatively recent and the searches I did sort of imply that this is an emerging market, they are still trying to convince insurance companies to do this, etc. Insurance is a very conservative industry. They tend to be somewhat slow to adopt new technologies. They are regulated by both federal laws that cover financial companies and also federal laws that cover medical companies (like HIPAA). So they have a huge regulatory burden and this makes change especially hard. Any new tech or new processes have to really be put through their paces to see if they still pass muster on multiple fronts. The de facto result is that insurance companies are kind of sticks in the mud.

Where I worked, a lot of the software was homegrown. It had been developed in-house. They didn't like hiring outside vendors/buying outside solutions. From what I gather, they were fairly cutting edge -- though, of course, it is possible that was just company hype. Since I worked there, I sometimes knew that some statements amounted to spin-doctoring. But I did only have an entry level job and was not really expecting it to turn into a career, so I am sure there is plenty that I missed.

Thanks for replying.

I just assumed it had already become "industry standard." Perhaps it was "becoming industry standard" instead. I think the article was specifically about car (not health) insurance too but I can't remember details. I went to go find it again before posting but of course I couldn't.

I also somewhat suspect (but I have no proof of course) that there is at least a little bit of data sharing to third parties that insurance companies can/do use to get more of the "big picture." Probably more car insurance than health insurance. I know such a thing as a "driving record" exists probably supplied by a company such as LexisNexis. My car insurance provided me a copy of my driving record.

So for example Person A has a pattern of behavior through different insurance companies that can be flagged while just looking at one insurance company's data might not show the data.

This is all wild speculation on my part more of a thought experiment on my part. Laws such as the FCRA are starting to address SOME of these issues but I'm not sure they are on top of all practices.

This type of tracking has become more common in the age of "big data."

https://personalreports.lexisnexis.com/access_your_personal_...

That's interesting though that they didn't like hiring outside vendors. I would think they would want outside vendors because their products were already vetted for regulation compliance.

That was not my area and I no longer work in insurance. I don't recall the details. But, yes, that is a thing.