New Tech insurer boosts efforts to fight fraud

 

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Copyright 2008 Gale Group, Inc.All rights ReservedBusiness and IndustryCopyright 2008 National Underwriter Company National Underwriter Property & Casualty

15 December 2008

Vol 15 Pg. 112 No. 47 ISSN: 1042-6841

6157721

1126 words


New technology insurer strengthens fight against fraud: sellers to develop, update the software to better take advantage of sources of information.



PRODUCT RECAP



With the economy stagnating, companies struggling to survive and workers lose their jobs by the hundreds of thousands of people every month, it is not unreasonable to anticipate increased fraud against the insurance business of all allegiances by desperate applicants.

Technology providers have been working hard on development and improvement of products designed to counteract this activity based on customer data and other information sources. Some of the newest product offerings:

* SPSS offers a suite of predictive analytics software and solutions designed not only to discover the existing forums of fraud, waste and abuse, but also to prevent future events, the Chicago-based company said.

[Illustration omitted]

"The insurance carriers use predictive analysis, not only to extract the standard yes-no answers, but detailed information and feelings behind the answers," added the company. "They are able to determine immediate instant approval of an insurance policy or a flag as potentially fraudulent by sending an alert message immediately for it to be further investigated. "

SPSS Risk Control Builder ", specially designed for carriers, helps in assessing risks in real time using a combination of business rules, predictive models and information obtained to optimize interactions with customers of the Insurance complaints process.

The product provides an interface driven by businesses to identify risk areas and measures, and a risk assessment engine to calculate risk in real time based on information and data collected at the time of the interaction with customers, the company said.

Cost: Projects start at $ 100,000 and scale upwards, depending on the size of the deployment and functionality, "said SPSS.

SPSS 'Clementine "and" Text Mining for Clementine, "which are applications of data mining, are used in the analysis of structured and unstructured data to discover patterns, to anticipate the results and improve processes, with the deployment and integration of predictive models, the company noted.

"Both can handle very large datasets," said the company. "[Applications] solve a wide range of challenging business problems, including customers chum, campaign effectiveness, customer value, marketing cost, fraud and risk analysis .

Cost: Prices for two from about $ 20,000, depending on the size of the deployment, the company said.

SPSS 'Dimensions', data collection and reporting of survey software helps researchers and organizations proactively integrate data on attitudes and preferences analysis of decision-making, said the company . It allows users to take control of the entire life cycle of reviews - from the preparation of studies for the management of the process of collecting data for the analysis of the distribution of results.

Cost: The price starts at $ 20,000 for the interview base web, with additional costs depending on the number of interviews and product data collection is chosen, the company added.

The SPSS 'Predictive Enterprise Services platform provides a foundation to manage and automate the entire process of analysis, the company said.

Cost: Projects start at $ 100,000 and scale, depending on the size of deployment and functionality.

SPSS "" Statistics "is a suite of statistical software used to solve the problems of research and business," said SPSS. It extends the power of predictive analysis, non-technical user to the expert programmer / analyst, and improves productivity in the use and data access, data preparation, analysis and reporting.

Cost: The price starts at $ 1799, with additional costs related to the number of licenses and modules, the company noted.

* Computer Sciences Corp. markets Fraud Evaluator, "describes the company as" a tool to detect fraud that combines several technologies for the detection and management of bad loans, from the first notification of loss through life of the application. "

According to Austin, Texas-based CSC, the product uses predictive modeling techniques, search for identity and an indicator of fraud rules engine to identify unique variables in the claim data indicative of fraud. Fraud evaluator triggers then the data collection and case management activities to the discovery of cases with the highest probability of fraud.

Using tools such as improving the analysis to the first notification of loss and throughout the life of a claim, insurers may increase the rate of referrals for bad debts, CSC said.

"By automating much of the process, companies can detect fraud consistent practice throughout the department, without putting more pressure on the setting to detect suspicious activity, and their special investigation units may close more cases of fraud and reduce losses, "said the company.

According to CSC, the benefits of this software include:

* Reduction of loss payments and reserves

* Improved consistency and quality of referrals

* Improved productivity for experts and management Sius

* Relief adjustment to be on the lookout for suspicious requests

* Workflow and automated statistical reports

* Implementation of best practices for fraud detection

* Ensure consistency of review and evaluation in all claims

Models and rules are based on the insurer and the historical experience of fraud can be updated periodically to identify new models, the company noted.

In addition, through a Web browser, investigators can view a list of all requests made to them in order of highest score first. This allows investigators to provide better fraud likely to least likely, the company said.

Cost: The company has refused to provide information on prices.

* ISO has published "ClaimSearch Illustrator," a desktop application that helps insurers to visualize relationships between data elements in ISO ClaimSearch claim records.

The product uses images and icons to create presentation-quality graphics. Connections to display the data elements of reports to determine whether a claim must be thorough, "said Jersey City, New Jersey, based on ISO.

The graphic display shows the links between data, as a vehicle identification number linked to multiple claims or claims related to multiple parties, the ISO said.

"The software allows insurers to organize data in many ways, add data manually, and to temporarily hide the data to create a visual image that can best help spot suspicious activity," said ISO. "In Furthermore, a function to merge changes in names and addresses to simplify the graphic display. It is also possible to click on a key piece of data to see details that might help in considering an application quickly. "

Cost: ClaimSearch Illustrator is available to customers free of charge, as part of their participation in the ISO ClaimSearch service.

27 February 2009

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