Fraud Detection Insurance
RiskShield 360° deters fraudsters
The increasing pressure of competition and ongoing industrialization further reduce the scope for insurance companies. Therefore, the handling of claims becomes more and more important for insurance companies. In this context, one essential factor is to prevent insurance fraud which causes an annual loss of about 4 billion Euros in Germany.
Insurance fraud is multi-faceted
The spectrum reaches from a slightly excessive invoice up to organized crime with faked accidents.
Therefore, it is essential to consider all these factors to identify fraud patterns.
Automated identification of fraud patterns with RiskShield 360°
With RiskShield 360°, the solution to detect fraud patterns, Arvato Financial Solutions and INFORM GmbH bet on a comprehensive check of all data sources relevant in the event of a claim by using various technologies.
Depending on the result a routing is initiated to the corresponding group of responsible employees. RiskShield 360° works with incriminating as well as exculpatory elements. Therefore, not only suspicious claims are identified and forwarded to the fraud experts but also »quick claims« are identified and approved for settlement. This allows a more efficient handling of unsuspicious claims which therefore can be settled more quickly. This finally leads to a higher customer satisfaction.
RiskShield 360° uses these technologies
- Fuzzy logic
- Conventional rules
- Detection of patterns on the basis of dynamic profiles
- Detection of networks
- Text mining
- Data mining
- Use of external data
Differentiation is crucial
Besides the technologies mainly the information is essential for the discriminatory power
of an automated detection of fraud patterns. The new approach of RiskShield 360° is to
consider your own available internal information as well as external information.
Best possible handling of claims and identification of fraud patterns
- Realization of considerable savings by a clearly improved discriminatory
power for the detection of
- Consideration of all relevant data sources (internal and external sources)
- Optimization of claims handling
(cost efficiency by specific
deployment of employees)