LARUS Announces Successful Implementation of Explainable Graph AI Technology for Detection of Insurance Fraud
In
"With our solution developed in collaboration with Fujitsu, the insurance company reduced the number of false positives and, in doing so, could redirect valuable investigative resources to critical areas of the business," said Lorenzo Speranzoni, CEO at LARUS. "We are looking forward to applying this solution to other vertical industries where GXAI can have a significant financial and social impact."
"Fujitsu Deep Tensor technology was a key advancement in Graph XAI research offering unparalleled insights into a wide array of application datasets," said
Background
The heterogeneity of insurance data makes it difficult to identify fraud as the underlying information is very complex and the data must be presented in a certain way to it. It is also imperative to target the right claims, at the right time. Examples of common false claim schemes include falsehoods about identity and location - when people use someone else's address to register and insure their cars because they know insurance rates are lower in that area, or fictitious infringements in road accidents and exchanges of roles in claims - when the subjects of claims are recurring over time but in different roles.
Solution Overview
Existing fraud detection applications use a claim-centric approach but it is more difficult to discover claims involving groups of subjects rather than single individuals. To address this problem, Galileo XAI uses an integrated and unified graph database whose nodes represent vehicles, claims and subjects and edges represent the relationships between them. The graph DB in the tested solution contained about 16 Million nodes and nearly 21 Million relationships.
Harnessing the graph database, it is possible to define classes of suspicious patterns - called rules, (expressed as cypher queries) - based both on topological properties and on node/edge attributes. These rules generate alerts that the insurance company can analyze and determine whether it actually represents fraudulent behavior or whether it is a false positive.
Rules are inherently not static and need to evolve with the dynamic nature of fraudsters. Using the graph topology in combination with Deep Tensor lets the analyst uncover new frauds and new behaviors, LARUS was able to automate a significant portion of the analysis process leading to improved efficiencies and reduction in need for cumbersome manual analysis.
Together with the pattern-matching features, Galileo XAI provides a visual tool to easily analyze the alerts found by the rules, allowing interaction with those subgraphs that match a desired pattern, in order to set the outcome of the investigation. By exploiting the connectedness of data and extracting new indicators based on the structure of the graph, the solution enabled the anti-fraud team to focus only on relevant groups of subjects or accidents reducing the set of false positives. Furthermore, these indicators are seamlessly used by Deep Tensor to constantly improve the results.
Finally, when AI algorithms may have a direct impact on human beings it is essential to give a clear explanation of the results as required by new laws including GDPR. Galileo XAI with its powerful graph visualization takes the explainability outputs given by Deep Tensor and shows them in a human understandable and friendly format for quick consumption thereby satisfying a core requirement for the adoption of AI systems.
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LARUS Business Automation S.r.l.
E-mail: [email protected]
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