Insurance Fraud Detection More Accurate, Efficient with SAS®

Latest version of SAS^® Fraud Framework for Insurance improves investigations, saves time

ORLANDO, Fla.--(BUSINESS WIRE)-- Insurance fraud is escalating – up 19 percent since 2009, says the National Insurance Crime Bureau (NICB). To detect more fraud, reduce false positives and improve investigator efficiency, insurers now have the latest version of SAS Fraud Framework for Insurance, from the leader in business analytics software and services. Enhancements include streamlined social network analysis, pre-built insurance content for better fraud detection, and the new SAS Financial Crimes Monitor.

“Insurers are catching up with the rest of financial services in preventing fraud. With questionable claims at all-time highs, insurers need advanced analytics and link analysis to identify and prevent fraud sooner,” said Stephen Applebaum, Senior Analyst for Property and Casualty Insurance, Aite Group. “Insurers benefit significantly: reducing false positives means processing legitimate claims faster, reducing overhead while improving customer experience and retention.”

Known for preventing, detecting and managing claims fraud across lines of business, SAS Fraud Framework for Insurance increases the efficiency and accuracy of SIU investigations. New social networking capabilities include a network hierarchy layout; greater flexibility to merge, hide or remove network entities; and adding annotations, such as text and images. The advanced functionality greatly improves investigator efficiency while reducing false positives, increasing return on investment per investigator.

SAS Fraud Framework for Insurance incorporates prebuilt insurance content, such as an extendible data model and industry-specific red flag business rules and models for detecting property and casualty fraud. The solution can also integrate external data from sources like NICB.

New in SAS Fraud Framework for Insurance, SAS Financial Crimes Monitor helps users to logically manage rules, models and alerts. The fraud scoring engine can detect more fraudulent activities by easily updating and maintaining business rules and advanced analytic techniques in the solution.

CNA and SAS – A Forceful Collaboration

“SAS is a powerful tool in fighting fraud – we’ve already seen good returns,” said Tim Wolfe, Director, Special Investigations Unit, at CNA. “Technology, especially predictive analytics, helps us consistently identify subtle indicators of fraud and better grasp how much fraud is out there. SAS provides a better gauge of claim fraud exposure, minimizing missed opportunities while accelerating the identification of sophisticated schemes that could go undetected. With this new SAS support, we anticipate a 20 percent increase in annual referrals to SIU.”

CNA uses the social networking component of SAS Fraud Frameworkfor Insurance to identify major cases of organized suspicious activity. “With the social networking component of SAS Fraud Framework for Insurance, we project 12 major cases annually in our business case, translating into approximately $500,000 in savings per year,” Wolfe explained.

The latest version of SAS Enterprise Case Management, which streamlines processes and investigations, and helps reduce costs and improve fraud prevention, was also announced today.

Today's announcement was made at SAS Global Forum, the world's largest gathering of SAS users, attended by more than 3,400 business and IT users of SAS software and solutions.

About SAS

SAS is the leader in business analytics software and services, and the largest independent vendor in the business intelligence market. Through innovative solutions, SAS helps customers at more than 55,000 sites improve performance and deliver value by making better decisions faster. Since 1976 SAS has been giving customers around the world THE POWER TO KNOW^®. SAS and all other SAS Institute Inc. product or service names are registered trademarks or trademarks of SAS Institute Inc. in the USA and other countries. ® indicates USA registration. Other brand and product names are trademarks of their respective companies. Copyright © 2012 SAS Institute Inc. All rights reserved.

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Source: SAS