Insurance

Stop revenue losses due to insurance claims fraud

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Prevent fraudulent claims

Every year insurance companies face the daunting task of sifting through millions of transactions to stop the billions in losses due to fraud.

Both individuals and organized crime rings rely on schemes like identity theft, false worker’s compensation and medical claimssocial security fraud and intentional vehicle accidents to scam millions.

Alessa uses advanced techniques like machine learning to detect suspicious claims and fraudulent activities that trigger investigations before being paid out. Features of the solution include:

  •  Transaction monitoring and screening
  •  Sanctions screening
  •  Advanced analytics like anomaly detection and machine learning
  •  Dashboards, workflows and case management

Features & Benefits

Transaction Screening

Monitor all transactions to intercept suspicious activities for investigation

Advanced Analytics

To detect complex fraud schemes across departments and systems

Risk Scoring

Configurable assessment of vendor and customer risks based on profile and activity

Reduce losses due to fraud

Studies estimate that fraud accounts for up to ten percent of incurred losses and loss adjustment expenses by the insurance industry. Alessa helps to significantly reduce these losses and exposure and enables insurance companies to keep their premium rates low.

 

Comply with legislation

In many jurisdictions, insurance companies are required by law to set up programs that identify fraud and take actions to reduce it.

 

Prioritize investigations

Use the risk scoring functionality within Alessa to identify the highest risk transactions and prioritize activities of assessors and special investigation units (SIU).

 

Be competitive

Reducing losses due to fraud, identifying and mitigating against risks and prioritizing the efforts of staff help to reduce operational costs and premiums for brokers and clients.

 

RELEVANT SOLUTIONS

Transaction Monitoring

Screen transactions in real time, periodically or by specific events to immediately detect errors, anomalies or control breaches and report as exceptions.

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Continuous Monitoring

See how Continuous Controls Monitoring allows management to continually review business processes to ensure that they are meeting their targets for effectiveness.

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