美国一家大型保险公司改进了在线保险欺诈检测
公司规模
1,000+
地区
- America
国家
- United States
产品
- IBM i2 Analyst’s Notebook
- IBM i2 iBridge
- IBM i2 Text Chart
技术栈
- Data Visualization
- Data Analysis
- Fraud Detection
实施规模
- Enterprise-wide Deployment
影响指标
- Cost Savings
- Customer Satisfaction
技术
- 分析与建模 - 实时分析
- 应用基础设施与中间件 - 数据交换与集成
适用行业
- 金融与保险
适用功能
- 采购
用例
- 欺诈识别
服务
- 数据科学服务
关于客户
该客户是一家总部位于马里兰州切维蔡斯的大型美国保险公司。该公司为全美 50 个州和波多黎各的 1500 多万客户提供在线汽车和医疗保险。该公司采用直接面向市场的销售模式，拥有 24,000 名员工，依靠多个电视广告活动而不是基于代理商的销售来创造收入。该公司努力预防和发现汽车和医疗保险欺诈并起诉肇事者。它力求在 20 天内支付、拒绝或保留任何索赔以进行进一步调查，而行业标准为 30 天。
挑战
这家美国大型保险公司面临着快速查明已提交索赔中的欺诈行为并加强预防方法的挑战。由于每位调查员要处理 35 项调查，因此公司需要准确、快速地从多个来源获取数据，包括保单、索赔和医疗账单数据；保险服务办公室 (ISO) 数据；以及来自 Thomas Reuters CLEAR 数据库的公共记录数据，以建立联系并找到欺诈者与其相关人员和企业之间的关系。除了确定索赔是否合法之外，该公司还认为，在向客户提供保险之前深入了解客户将有助于防止欺诈。它寻求一种系统来帮助增强欺诈预防和检测能力。
解决方案
该公司实施了 IBM i2 软件，以持续预防和检测汽车和医疗保险欺诈。该公司购买了 IBM i2 Analyst's Notebook®、IBM i2 iBridge 和 IBM i2 Text Chart 软件的多个许可证，使用这些软件从所有来源获取报告和数据，并快速将非结构化数据转换为清晰的格式。该解决方案可帮助该公司获取 IP 地址、扫描文档参考、电子邮件地址、驾驶执照信息、犯罪记录、判决或已知的欺诈连接数据，以链接多个来源并识别可能保持匿名的关系。i2 软件的世界级可视化功能可帮助该公司获取数十万个数据点并突出显示可重复的模式，精确定位相关实体和相关连接，并识别可能导致索赔被拒的共同点。
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