Helping Businesses Cut the Cost of Fraud & Drive Performance

Using our AI, ML Fraud Detection, and Investigation Platform we can help businesses cut the cost of fraud and drive performance enhancements.

by Andy Pagett, FCMI 

The recent announcement by the IFB (in the UK Market) that it would be adding an AI solution to its current system offerings to monitor its vast wealth of Insurance data should be of no surprise to the experienced fraud and indeed operational managers among you.

For many years as an industry, we have been struggling with the challenges presented by organised fraudsters who always appear to be two or three steps ahead of us as we introduce new controls and protections to our processes.

Second guessing the fraudsters next step, target, or scam with them operating under the radar and outside the constraints of a law-abiding fully regulated environment can be pure guess work.

 So how can we redress the balance?

Creating the right data environment to develop a real time  ‘single customer view’  is the first step; capturing and formatting your structured and unstructured data, to include digital documentation.

From here you can truly gain greater data insight and monitor customer activity across the full insurance lifecycle by applying more sophisticated solutions which can analyse behaviours, interrogate all the data, and support better decision making as well as creating new opportunities to introduce a degree of both process and decision automation.

Sound interesting?

We are all seeking ways to reduce the fraud risk whilst tackling the internal demands for streamlined operations and business transformation.

Applying our People/Process/Systems strategy to all aspects of the business can be a challenge but with the right choice of software or system this can be a game changer.

In a post lock down environment, we are likely to continue with a degree of remote working, creating the challenges in monitoring productivity and maintaining security, whilst developing new ways to support and train our staff.

We strive to create an environment for simple straight through processing to meet future customer demand and expectations and finally introduce ‘real time’ analytics to support  automated decision making, that can be multi-functional, covering all aspects of the customer journey.

Greater insight, monitoring, predictions, and scenario planning can be achieved through the use of AI and Machine Learning so how close are you to achieving this?

As indicated, the starting point is to create the right data environment, a single collection point to allow you to analyse all aspects of your data.

Then select the best solution for you that will support your full Business Transformation programmes. A single solution that can deliver on all fronts to provide capability, adaptability and includes future enhancements that you manage and control and all for a low cost providing an excellent ROI.

Introducing DataWalk

Why not take a look at our ‘Next Generation’ AI – analytical detection and investigation solution – DataWalk – which is currently deployed and used by leading insurers, law enforcement & government agencies.

In America, the system has been adopted by a wide range of Government Bodies and industries to support a variety of diverse use cases from anti-money laundering, anti-fraud, intelligence analysis, through toscenario planning and infectious disease analysis.

DataWalk applies AI, Machine Learning, and flexible rules-based technology against both internal and external data sources to assess the likelihood of a case being fraudulent and produces a single ‘adverse fraud score’ which can be applied to both automate ‘high risk’ referrals for investigation or fast-track ‘low risk’ claims for straight through processing.

Where deployed, the solution has significantly reduced the false positive rate to (<10%) across a variety of Insurance product lines.

Add to this the ability to use the system as an ad hoc investigation tool as well as a platform to ingest data from various sources to create a single customer view its combined capability can reduce the need for multiple solutions.

This scalable solution can support you at whatever stage you are in your business transformation journey starting at an entry level rule-based solution through to a full-blown AI & ML analytical platform with configuration of the system tailored to each individual client’s requirements, you can be up and running (and self-sufficient) in a matter of weeks.

If you are interested in more data solutions in the Insurance Industry, contact us now to see how we can help.