It has been a growing concern that Asia Pacific has the highest incidence of medical claims fraud compared to EMEA and US. And each year consumers bear the brunt of rising medical and healthcare costs.
Today’s fraudsters use highly sophisticated criminal tactics and masterful exploitation of organizational vulnerabilities. However, many insurers still rely on simple transactional monitoring systems to detect fraudulent activity which not only fail to review ALL medical claims for fraud but is also time consuming and too reliant on human review.
The answer lies in ANALYTICS. With digital acceleration and advancement of the times, it is critical that insurers evolve further in their strategy and detection capabilities to stay ahead of a fraudster’s mind.
- To quickly and efficiently and seamlessly, detect, prevent, and manage both opportunistic and organized fraud across multiple lines of business.
- To process claims without the checks and balances that come with human interaction.
- To uncover hidden relationships among fraudsters, enabling insurers to focus on stopping the highest-value fraud networks.
Join us as we talk more on how SAS analytics can support Life & Health and Non-Life insurers with an automated end-to-end solution to detect claims at each FNOL using a hybrid approach of rules, AI, Machine Learning and social network capabilities; resulting in time saved and a reduction in fraudulent claims payment.
Automated Business Rules, Data Visualization, Advanced Analytics, Artificial Intelligence, Machine Learning, Alerts, Text Mining, Anomaly Detection, Network Link Analysis
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Country Managing Director
Head of Industry Consulting, Asia Pacific
Risk Practice Lead
Regional Solution Director, Fraud & Security Intelligence
Roderick M. Vega
Partner Forensic & Integrity Services