Fraud Detection and Prevention

Fraud is big business. It is a global, cross-industry and growing issue. Indeed, many companies expect to lose roughly 5 % of revenue to fraud each year, and even worse than the monetary loss that fraud incurs is fraud’s toll on customer trust and a company’s reputation.

Global Telecommunication fraud is estimated at more than $40 billion per year.

Losses from Online Banking fraud rose by 48% in 2014 compared with 2013 as consumers increasingly conducted their financial affairs on the internet.

Fraud detection is about connecting the data points to discover potential fraudulent behaviour before it happens. This starts with finding interactions between products, locations, and devices and then mapping those data points to individual users, customers, and/or employees. This approach effectively connects together vast quantities of knowledge with all of the people who somehow interacted with that knowledge.

In the Insurance industry at least 10 % of all insurance claims are inflated or fraudulent – costing the industry as much as €30 billion annually.

Detecting insurance claims with greater certainty, streamlining claims processing and making claims reviews more productive is exigent. Insurers are interested in questions like:

Are they getting the desired ROI?
How much fraud is being uncovered
How much loss is avoided
How much time is saved?

Predictive analytics technology helps you to instantly determine which claims qualify for immediate approval, flag suspicious claims for follow up and discover which customer behaviour is potentially fraudulent.

Presidion’s Fraud Detection and Prevention Solution can be applied across a range of industries including:

Insurance

Financial Services

Telecommunications

This solution enables you to:

Detect fraud consistently throughout the life of a claim or across your customer base.
Predict and prevent fraud at each stage.
Automatically detect new forms of fraud with analytics that “learn” from your data.
Support the overriding claims adjusting goal of moving claims to closure quickly, keeping costs down while providing a high level of service.

Fraud Detection and Prevention Resources

Case Study

Santam Insurance

Santam saves millions in processing claims and detecting fraud

Santam processes its claim 70 time faster using Predictive Analytics Solution and detect multi-million fraud cases.

ROI: 244%
Payback: 3.7 months
Avg annual benefit: R34,407,024 (US$3,815,085)

Case Study

Insurance Bureau of Canada

Outsmarting fraudsters with fraud analytics – IBC protects honest policyholders by detecting and prosecuting organized insurance fraud.

Quickly found suspects and their claims reducing investigation efforts
Found a previously unidentified suspect fraud ring
Gathered more information against suspected fraudsters with a higher degree of confidence

Infographic: Detecting Fraud using Predictive Analytics