85% reduction in false positives using real-time fraud detection in claim processing
Created a system for identifying traits of both suspect and legitimate claims during claim processing to provide fraud detection
The client is one of the leading insurance providers and required a near real-time system to detect fraud and flag the fraud with fewer false positives during claim processing. The existing system was unable to handle large numbers of queries and was inefficient in fraud detection and processing valid claims.
We analyzed and mapped their complete data, and scaled and integrated the data and insights into a custom-tailored fraud database. We also created a system for identifying traits of both suspect and legitimate claims during claim processing.
With our real-time fraud detection system, the client was able to achieve 30% increase in effective fraud detection and 85% reduction in false positives.