Insurance Fraud Prevention
01. The Challenge
A Also for indemnity insurance companies it is increasingly important that fraud is better prevented than detected. This specific client has large amounts of heterogenic data, from internal as well as external sources. The processes to analyze this data are very time consuming and the insight into risks was so far limited. This started already when searching for the history of investigations into fraud.
02. The Process
The goal was to get more insight into the connections and similarities between the different investigations and the different business lines, amongst others by remodeling the internal data and also to save time and costs on processes. At a later stage additional data sources could be connected. The large amounts of data from the history of fraud investigations have been integrated into the data model and for the detection of fraud and misuse, advanced analytics were added on different layers. Using case management, the results have been visualized and the cooperation between internal and external parties has been optimized.
03. The Solution
The solution from BusinessForensics has created a 360 degree integrated risk overview on the aggregated data related to the several business lines. Eventually the solution will bring a larger cost saving following the optimization of the process and better insight in and between investigations. Also agreements between departments have been optimized realizing an extra protection against fraud. The next step will be to use the knowledge that has been collected in the BusinessForensics application for prevention.
Proof of Concept
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