Not just USA- in UK applying business rules gained from big data analytics to flag potential fraud has lead to auto insurance crime rings being identified.
One hurdle has been the inability to analyse data already collected. Take the humble Claims Notification Form (CNF) British claimants have to submit to insurers. Most of the fields are not analysed as they are free-text. Yet in these are the seeds of discovery. Discovering fraudsters.
See how one insurer has increased fraud detection by over 40%
Markerstudy, again in the UK, states: -
"One early project using big data analytics allowed us to make phenomenal financial improvements by detecting, at the point we were quoting for insurance business online, the possibility that a customer would commit fraud"
Both 360Globalnet and Markerstudy augment human intelligence with algorithms that derive insight from "big data".
Lou Lwin of Markerstudy says- "with the appropriate balance between natural and induced competencies, digital transformation is not only achievable, it is a pathway to success". Well worth reading his article "Transformation- it's all about competence" in Raconteur
The staggering level of criminality costs us all, adding $400 to $700 a year to premiums we pay for our homes, cars, and healthcare, the feds say. There are simply not enough investigators to put a significant dent in the criminality, so the industry is turning to the machines.
https://www.fastcompany.com/40585373/to-combat-fraud-insurers-turn-to-artificial-intelligence
