“The single biggest challenge is putting in the appropriate controls and team to ensure that you find the fraud but that you don’t disrupt the customer experience in the process.”
Assemble alerts from multiple monitoring systems automatically. Associate them with common individuals or entities. Then automatically prioritize and route them to appropriate team members for investigation. In partnership with SAS, Scyllogis are now able to bring to the market a fraud framework that enables you to:
Find more fraud faster. Our unique hybrid approach combines business rules, anomaly detection, predictive analytics and social network analysis. The result? You can uncover hidden relationships and detect subtle patterns of behavior in masses of data – both structured and unstructured – that would otherwise be missed.
Prioritize investigations. Don’t waste precious investigation time. Our solutions analyse all related activities and relationships at a network dimension to detect previously hidden linkages and uncover organized fraud rings. And you can ensure that the highest-value cases get prioritized appropriately.
Streamline processes. Our comprehensive case management tools facilitate more efficient investigations, meaning you can capture and display all pertinent information without corrupting the system with duplicate data entry
Reduced fraud-related losses. Fewer false positives. And greater investigator efficiency. Our insurance analytics framework, powered by SAS technology helps you detect, prevent and manage:
Detect claims fraud. Detect and prevent both opportunistic and professional fraud throughout the claims process.
Identify underwriting fraud. Prevent premium leakage at the point of sale and renewal.
Spot rate evasion. Spot rate evasion tactics during the quote process – before you issue a policy.
“For claims fraud prevention and detection, an insurer needs a highly professional organisation, and the best people capabilities supported by excellent data analytics”
Detect more fraudulent activity. Our fraud detection solutions gives you a broader view by processing all data through advanced analytics models and combining it with rules engines. You’ll be able to detect previously unknown schemes with customised anomaly detection methods, and spot linked entities and crime rings to stem larger losses.
Prevent fraud losses before settlement. Real-time daily batch scoring catches fraud immediately. Find loss padding in similar claims. Identify repeat offenders and uncover insider or collusive fraud by integrating staff data and audit records, and applying risk- and value-based scoring models to prioritize output for investigators.
Lower loss-adjustment expenses. You can greatly reduce false positives using a sophisticated fraud scoring engine, improving investigator efficiency and ROI with advanced case management tools. By prioritizing higher value networks and conducting more efficient and accurate investigations, you are able to capture all claims settlement amounts within the system to reuse with similar claims in the future.
Get a consolidated view of fraud risk. Identify cross-brand/product fraud by seeing customer claims and policies for all lines of business. Continuously improve models and adapt the system as needed to address changes in fraud trends. Understand new claim threats and prevent substantial losses early using social network diagrams and sophisticated data mining techniques.
Gain a greater competitive advantage. Generate fewer false positives to gain greater satisfaction of legitimate customers. More diligent, effective fraud detection methods can actually discourage fraudsters from targeting your organization, and satisfy regulatory requirements by better managing fraud.
Don’t accept fraud as a cost of doing business.