We prevent financial crime for insurance

BusinessForensics is a leading provider of fraud surveillance, KYC/CDD, and special investigation solutions for insurance companies.
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ForensicCloud Platform

One modular, cloud-based platform.

ForensicCloud for Insurance

ForensicCloud
Platform

Our cloud-first platform is built for today’s insurance company — meaning faster updates, less provisioning, and lower infrastructure costs for you.

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Modular

Today, you need KYC. Next year, transaction monitoring. No matter your requirement, our modular solutions can handle it.

Scalable

Being built on the cloud helps us cater to insurance companies of all sizes — from SMB's to top brands.

Secure

We provide insurers with a compliant and secure hosted infrastructure, in accordance with ISO standards and ISAE3402 recommendations.

ForensicCloud in 60 seconds

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ForensicCloud for Insurance

The Power of Visualization

Client Risk Intelligence (CRI) aggregates multiple data sources, across your fraud and claims process, to provide you with real-time visualization and analysis of your networks, transactions, and risk signals.

As a result, you’re able to focus on high risk cases, detect risk early, and take immediate action to minimize your exposure to regulatory violations and damages.

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A legacy approach to investigating fraud is 8x longer for consumers
billion
is lost through all non-health insurance fraud
percent
of claims costs paid annually are to fraudulent claims
million
Average monetary fine last year (est. in EUR)
Know your customer (KYC/CDD)

Collect, verify, and validate all information about your clients, then easily generate and assign a risk rating.

Special Investigations

Use data-driven investigations and workflows to handle all compliance alerts, irregularities, and integrity risks.

Fraud & Risk Surveillance

Detect fraudulent claims, handle alerts, and reduce false positives so you can identify integrity risk more accurately, while your investigators work more efficiently.

Client Risk Intelligence for Insurance

A dynamic 360° risk profile to detect, prevent, and manage claims fraud.

Client Risk Intelligence (CRI) monitors, identifies, and aggregates all risk while using our proprietary scoring model to assign an integrity risk score to each customer and scenario.

✔️ Improve outcomes while reducing the cost of counter-fraud efforts
✔️ Optimize fraud management to make investigations more efficient and effective
✔️ Reduce false-positives and improve the effectiveness and efficiency of investigators
✔️ Manage fraud investigations from on-boarding and detection to conclusion
✔️ Peace of mind in having a secure end-to-end fraud management process
✔️ Easily meet regulatory compliance obligations

The dynamic risk score can be used as input for SIRA, IFRS, and as a benchmark for reducing your overall risk profile.

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Know Your Customer (KYC) for Insurance

Know Your Customer
KYC/CDD Features

Take charge of your KYC process, accurately identify policy holders, and maintain compliance with EU Anti-Money Laundering directives. 

Identify insurance fraud — before it happens.

IDENTIFICATION & VERIFICATION

✔︎ Separate fraudsters from valued customers faster with predefined parameters
✔︎ Standard workflows
✔︎ Automated verification process
✔︎ Seamless integration with internal and external data sources for agents
✔︎ GDPR compliant

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SANCTIONS & PEP SCREENINGS

✔︎ Sanction lists
✔︎ PEP lists
✔︎ Adverse media lists
✔︎ Automated IVR/EVR checks
✔︎ White listing

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CLIENT RISK RATING

✔︎ Scoring model for unambiguous risk rating
✔︎ Comparison of risk rating within peer groups
✔︎ Periodic account reviews initiated from signals and requests (internal and external)

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ForensicCloud for Insurance

Benefits of the KYC/CDD Module

  • End-to-end KYC process enablement for insurance

  • One central application for all case information

  • SIRA and GDPR compliant

  • Full integration with other modules

  • Intuitive screens providing situational awareness

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Special Investigations for Insurance

Special Investigations

Take control of claims alerts and irregularities with straightforward workflows, Extended Due Diligence (EDD), and case management with data source integration — putting all your relevant case details in one place.

Conduct a compliant claims process — from case management to reporting.

CASE MANAGEMENT

✔︎ Automated and standardized workflows to handle all alerts and cases
✔︎ Complete claims process audit trail for increased accountability
✔︎ W7 Standard for consistent data interpretation

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DATA-DRIVEN INVESTIGATION

✔︎ Link analysis between alerts and cases, situational awareness, and actionable intelligence
✔︎ Strong visualization of complex risks through network diagrams and behavioral profiles
✔︎ Connectivity with internal data sources, official authorities, and registries

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REPORTING

✔︎ Personalized home screen
✔︎ Customizable interface
✔︎ KPI dashboard, standard letters, and reporting
✔︎ Comprehensive dashboard with to-do's, action items, and journal

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ForensicCloud for Insurance

Benefits of Special Investigations

  • Fully integrated with KYC, AML, and Fraud Surveillance modules

  • End-to-end Special Investigations process

  • A central application and standard workflows for all departments

  • Intuitive screens with advanced network analysis

  • GDPR compliant and high-quality case files, guaranteed by our proprietary W7 Standard 

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Fraud & Risk Surveillance for Insurance

Fraud and Integrity Risk Surveillance

Detect fraudulent claims, handle alerts, reduce false positives, and identify integrity risk more accurately — so your investigators can work more efficiently.

Monitor claims-related patterns and scenarios, process complex events, and integrate external data sources to reduce costs and eliminate working in silos.

COMBINING RULES

✔︎ Integration of rule, feature, scenario, and profile-based monitoring
✔︎ Signals and context from multiple monitoring tools are combined
✔︎ Audit trail and testing on rules maintenance

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MONITORING AND INTERVENTIONS

✔︎ Real-time monitoring, rules adjustments, assessments, and interventions
✔︎ Hold/stop-release routines based on fraud markers for processing instant, real-time payments
✔︎ Integration with all relevant internal and external data sources

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COMBINED ANALYSIS & INVESTIGATIONS

✔︎ Actionable intelligence for rapid alert shaping, handling, and analysis
✔︎ Link analysis for integration of all investigation processes, from all modules
✔︎ Network analysis and behavioral patterns for situational awareness

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ForensicCloud for Insurance

Benefits of Fraud and Integrity Surveillance

  • Fully integrated with the KYC/CDD, Special Investigations, and AML & Sanctions Surveillance modules

  • End-to-end fraud and integrity risk surveillance process for insurance companies

  • One central application and standard workflows for all processes, agents, and departments

  • Combined network analysis and behavioral patterns for situational awareness and actionable intelligence

  • Real-time surveillance with flexible and adaptable monitoring for your policies and procedures

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How it Works

A Three-Step Process to Get Started

01
01
Challenges

We identify and address your most critical challenges, then propose a road map to achieve even better results.

02
02
Value

We demonstrate how each result provides the most value for your organization, and set up reference visits so existing customers can share their experience with you.

03
03
Agreements

Once a solution has been identified, we move forward with the license, project, and service agreements.

01
Challenges
We identify and address your most critical challenges, then propose a road map to achieve even better results.
02
Value

We demonstrate how each result provides the most value for your organization, and set up reference visits so existing customers can share their experience with you.

03
Agreements

Once a solution has been identified, we move forward with the license, project, and service agreements.

Return-on-Investment (ROI)

Proof of Concept

Need to make a financial case for acquiring fraud, KYC, or CDD solutions for your insurance company? 

With a proof of concept, we use your data to show you the savings potential and ROI of moving forward with an integrity risk management solution today.

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