Last year, calling auto insurance fraud “systemic” and an “industry” that costs its taxpayers $1.6 billion annually, the Ontario government vowed to create a Serious Fraud Office to tackle the problem of lawyers, clinics and other actors who take advantage of the system. In the healthcare space, according to CLHIA, all Canadians pay for healthcare fraud. In North America alone, it is estimated that 2–10% of all healthcare dollars are lost to fraud. This means higher costs for everyone.
The challenge to insurers lies in the velocity, variety and volume of networked transactions, which increase threat exposure, and in using limited investigative or audit resources effectively. How do you find a needle when you're not even sure what haystack its buried in? Join this session to hear about new trends, techniques and tools to proactively find and prevent fraud in a variety of insurance applications.
You Will Learn How To:
- Illustrate how deep analytics and machine learning can increase fraud detection
- Identify ways to reduce false positives, cost per claim and time to payout
- Recognize how to improve the investigation processes with visualization while using limited investigative and audit resources
- Apply best practices in approach, scope and data management to ensure your project stays on track and delivers results
Recommended Prerequisites: None
Field of Study: Auditing