You don't have to accept claims fraud as a cost of doing business. SAS® Detection and Investigation for Insurance provides an end-to-end solution for detecting, preventing and managing both opportunistic and organized claims fraud across multiple lines of business, with components for fraud detection, alert management and case handling.
Key Features
- Data management. Includes an insurance-specific data model that consolidates data from internal and external sources – claims systems, watch lists, third parties, unstructured text, etc. – and seamlessly integrates existing solutions.
- Advanced analytics with embedded AI. Provides a broad set of advanced analytic and AI techniques, including modern statistical, machine learning, deep learning and text analytics algorithms – accessible from a single environment.
- Rule and analytic model management. Includes prepackaged heuristic rules, anomaly detection and predictive models, and lets you create and logically manage business rules, analytic models, alerts and watch lists.
- Detection and alert generation. Calculates the propensity for claims fraud at first submission with a scoring engine that combines business rules, anomaly detection and advanced analytics; then rescores claims at each processing stage as new claims data is captured.
- Alert management. Combines alerts from multiple monitoring systems and associates them with common individuals for a more complete view of risk for individuals or groups.
- Social network analysis. Provides a unique visualization interface that lets you go beyond transaction and detailed claims views to analyze all related activities and relationships at a network dimension.
- Search and discovery. Lets you perform free-text, field-based or geospatial searches across all internal and external data, and refine searches using interactive filters.
- Case handling. Streamlines operations with a configurable workflow that provides a systematic means of conducting investigations, and captures and displays all information pertinent to a case.
- Flexible deployment options. Enables you to choose the deployment option that works best for you – complete hosting by SAS, deployment at your site or a combination of the two.
Demo
See SAS® Detection and Investigation for Insurance in action.
Detecting and preventing fraud is a global challenge for insurers. Find out how our insurance fraud detection and investigation software uses analytics and machine learning to help you identify claims fraud before claims are paid.
This solution runs on SAS® Viya®, which has the breadth and depth to conquer any analytics challenge, from experimental to mission critical. SAS Viya extends the SAS Platform to enable everyone – data scientists, business analysts, developers and executives alike – to collaborate and realize innovative results faster.