Claims leakage detection
Claims leakage detection is finding the avoidable overpayments in a book of claims, such as wrong splits, missed recoveries and drifting reserves, ideally before the money leaves rather than in a later audit.
Detection can be retrospective, auditing closed claims to size the problem, or live, scoring open claims to catch a leaking decision before payment. The live version is where the money is actually saved.
Why it matters
Leakage does not appear on the P&L. It is absorbed into the loss ratio. Detecting it while the claim is still open is what turns measuring the problem into stopping it.
In Mysa
Mysa scores every decision while the claim is still open, so a call that would leak gets flagged before payment, not found in an audit months later.
Related terms
See it on Mysa