Harnessing Claims Fraud Analytics
Helping Insurers tackle the increase in Fraudulent Claims connected with the Global Recession
Fraudulent practices have accompanied insurance since its inception but the way such practices have been playing out and their operating modes have evolved throughout time.
Fraudulent practices have accompanied insurance since its inception but the way such practices have been playing out and their operating modes have evolved throughout time.
As we move into a global recession, history teaches us that we should expect to see increased levels of fraud across all aspects of society, and insurance and health insurance providers will not be immune from this.
Benefit from Advanced Analytics & Machine Learning (ML)
Today, many insurers have already invested in people and processes to help tackle fraud, expanding their anti-fraud arsenal of technologies and integrating them into their underwriting systems.
In this fireside chat, we will outline how advanced analytics and machine learning techniques, are offering the additional line of defense within the claims process. Our conversation will draw on global experiences, industry trends and real-life examples from some of the best practices that every insurer needs to consider.
The need to move to real-time detection is NOW. We’ll illustrate how insurers can include claims fraud analytics within their digital transformation program; and how deploying technology can help insurers today focus on the key claims to take out of a straight-through process and minimize false positives.
Benchmark against real-life success stories
- Learn from our extensive global experience of real-life success stories of deploying advanced analytics
- Understand the key considerations that every insurer should consider before embarking on a machine learning claims program
- Consider how a hybrid approach of business rules and analytics can effectively support the claims management process allowing real time take-out of suspicious claims from the Claims Management process
Gain KPIs for your enterprise
- What are the typical fraud detection and false positive rates that insurers should be achieve for P&C and Health
- Typical ROI from analytical investments in claims fraud detection
- How to get started and timelines for implementation
Presenters:
David Hartley
Global Director, Fraud and Financial Crime Practice
SAS
David Hartley Global Director, Fraud and Financial Crime Practice, SAS David Hartley is a 20-year SAS veteran based in the UK and has global responsibility for the direction and development of specific analytics solutions to address insurance fraud detection and prevention and leads of team of insurance fraud global experts. The team also support health insurers in their pursuit of fraud, waste and abuse. SAS entered this space in 2009 and now has just under 100 insurers and ten country consortiums across the world using SAS to detect suspicious claims, potential fraudulent new business applications, reducing false positive ratios in investigation and using the solution to identify potential fraud within the various third parties involved in the claims process including agents, garages/motor repair shops, doctors/medical providers etc. as well as possible internal fraud within the insurer. David brings over 35 years of insurance experience to SAS. He was part of a small team that established Lloyds Bank as the largest bancassurer in the UK in the mid 1990’s. Prior to this he spent 7 years at Eagle Star (now part of Zurich Insurance) working on both central data repositories, the application of data intelligence (including fraud detection and customer intelligence) and running direct marketing teams, and was part of the management team that established their successful personal lines direct writer in 1989. David is a graduate in Business Studies from the University of Aston In Birmingham, England and is an Associate of the Chartered Insurance Institute, a Fellow of the Institute of Direct and Digital Marketing and holds Diplomas from the UK’s Chartered Institute of Marketing, and Market Research Society. Outside of work, David has been happily married for 30 years, and is the father of 4 young men, and is a life-long Manchester City supporter. He is also the Chairman and Founder of a global medical research charity and support group, The XLP Research Trust. LinkedIn profile - linkedin.com/in/davidghartley
Kenneth Koh
Principal/ Director of Insurance, Global Financial Services Practice
SAS
- Kenneth is an experienced management executive with more than 20 years of experience in marketing and distribution management, having worked for global insurance institutions, with focus on marketing/ business transformation and effectiveness in area of marketing and customer relationship management
- With SAS, Kenneth has supported transformation activities of FSI clients to become more customer centric using hybrid of technology and business advisory work. Provided business advisory support to help customers develop their business strategies using data driven analytics in CRM, distribution management and operational efficiency. Participated in projects involving customer analytics, operational improvements, data management, campaign management and digital transformation.
- Deep expertise in database marketing, customer analytics, customer experience design/management and business advisory and as an insurance SME, Kenneth has played a pivotal role in providing technology guidance to insurers on the end to end capabilities for IFRS 17 compliance.
- Kenneth holds a post graduate degree (Master of Science) in Marketing & Consumer Insight from the Nanyang Technological University Business School of Singapore
