Where human capabilities fail

Allianz Insurance uses an analytics solution to uncover insurance fraud

The most common insurance fraud is vehicle-related, including simulated car accidents and inflated damage claims. But owners of immovable properties or households are also testing insurers’ internal audit mechanisms. With the right fraud-detection system in place, you can save millions. Allianz Insurance has proven that.

Maya Mašková, the head of the Internal Audit Department at Allianz, says they needed to replace their outdated fraud-detection system with a modern analytical solution that would reduce the time and resources required while improving their success rate. “We needed to automate more of the process,” says Mašková. “More importantly, we needed assurance that we were finding the suspicious behavior.”

The users can browse through all of the monitored elements giving us a real boost in savings and efficiency.
Maya Maskova, CSS

Maya Mašková
Head of the Internal Audit Department

Seeing what you can’t see

Allianz Insurance chose the SAS® Fraud Framework for Insurance because it uses a hybrid approach to sift through the data. The solution uses multiple statistical techniques to look at the data from all angles. “SAS uses embedded analytical models to uncover things that the human brain cannot,” says Mašková.

Suspicious behavior is identified automatically and made available to investigators every day. “These cases are given a priority rating so the investigators can focus on cases with the highest probability of fraud or highest potential financial damage,” says Mašková.

Another very important capability helps Allianz investigators reveal social networks – this is particularly useful in uncovering organized fraud. The system presents a visual of the links and relations of all entities associated with the suspicious case. The investigator can now see connections that couldn’t be found using routine examination techniques.

What’s the payoff?

There are a lot of benefits to using this hybrid approach: savings in claims compensations, increased number of identified fraud cases and improved operating procedures. And the work of investigators is easier now. But there’s an even more important benefit – organized insurance fraudsters tend to avoid Allianz now.

In the first six months after implementing the solution, Allianz identified 1,161 insurance fraud cases worth more than CZK 62 million. That was 426 fraud cases – and CZK 10 million – more than in the same period of the year before.

Other benefits:

  • Investigated 26 percent more cases.
  • Submitted 40 percent more proven fraud cases for criminal prosecution. 
  • Saved about CZK 110 million a year by reducing the number of fraudulent claims paid.

“The decision to choose SAS was a good one. We’ve been able to expand the number and type of insured events that we examine. The users can browse through all of the monitored elements giving us a real boost in savings and efficiency,” concludes Mašková. “We’ve even uncovered some major organized fraud groups.”



Increase the efficiency of the claims investigation and get more assurance that the right claims are being investigated.


SAS® Fraud Framework for Insurance


  • Identified 1,161 insurance fraud cases worth more than CZK 62 million in the first six months after implementation.
  • Investigated 26% more cases.
  • Submitted 40% more proven fraud cases for criminal prosecution.
  • Saved about CZK 110 million a year by reducing the number of fraudulent claims paid.

Les résultats présentés dans cet article sont spécifiques à des situations, problématiques métiers et données particulières, et aux environnements informatiques décrits. L'expérience de chaque client SAS est unique et dépend de variables commerciales et techniques propres, de ce fait les déclarations ci-dessus doivent être considérées dans un contexte. Les gains, résultats et performances peuvent varier selon les configurations et conditions de chaque client. SAS ne garantit ni ne déclare que chaque client obtiendra des résultats similaires. Les seules garanties relatives aux produits et services de SAS sont celles qui sont expressément stipulées dans les garanties contractuelles figurant dans l’accord écrit conclu avec SAS pour ces produits et services. Aucune information contenue dans le présent document ne peut être interprétée comme constituant une garantie supplémentaire. Les clients ont partagé leurs succès avec SAS dans le cadre d’un accord contractuel ou à la suite de la mise en œuvre réussie du progiciel SAS. Les noms de marques et de produits sont des marques déposées de leurs sociétés respectives.

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