According to Gartner, Fraud Analytics and detection tools, when efficiently applied to P&C claims, can go a long way in controlling claim expense, reducing fraudulent losses and payouts and assisting in accurate reserving.
While technologies are available to support these requirements, the adoption among P&C insurers has been low. According to Gartner, if insurers implement technology based fraud solutions, they might be able to reduce fraud related losses by 10% within a year of deployment.
Using predictive models and smarter business rules, fraud detection solutions can hasten the detection of fraudulent activities and patterns.
In addition insurers can also leverage modern technological trends such as GIS, Social Media, Unstructured Data Extraction from image files, content management solutions, etc.to dramatically reduce costs from fraud and abuse, to close claims faster and with greater certainty, as well as to make more efficient use of investigative resources
Tech Mahindra’s Fraud Analytics System (FAS) is a case management framework that determines the existence of fraud potential in a claim early in its lifecycle and enables straight-through processing of insurance claims. This is business rules, processes, analytics and case management unified in a single platform.
The application is developed using EMCDocumentum xCP 2.0. The system is meant to enable an organization to use one central repository for assimilating, storing, using claim related material collected to process a specific insurance claim. The workflows developed are customized to include insurance processes with an adequate level of integration with external Analytical Engines for Fraud Analytics.