Insurance Fraud Management

One-stop solution to address all types of frauds across insurance services.
Overview
Subex's Insurance Fraud Management provides 360° fraud protection across various services by leveraging advanced machine learning and a hybrid rule engine. The solution combines the rules engine with advanced artificial intelligence/machine learning capabilities to help insurers detect and prevent insurance fraud.
Hybrid Rule Engine
The heart of Subex's Insurance Fraud Management solution is a hybrid rule engine that covers detection techniques like thresholds, expressions, and trends. Rule engine comprises of a combination of threshold rules, geographic rules, pattern (sequential) rules, combinatorial rules, ratio/proportion-based rules, negative rules, hotlist-based rules, etc., which enable you to monitor advanced threats. Intelligent alarm qualification designed based on hidden Markov models ensures an analyst catches at least 80% of fraud by only having to go through no more than 20% of the alarms on the alarm stack.
Artificial Intelligence-based fraud detection
Subex's Insurance Fraud Management system is integrated with machine learning algorithms to mine historical data from fraudulent behaviors to create supervised and unsupervised models. These models enable organizations to find hidden patterns in data for fraudulent activities, which reduces the time-to-detect fraud significantly. Subex has multiple sets of proprietary ensemble models with the capability of state-of-the-art patented automated hyperparameter tuning and autonomous model selection based on the properties of data, such as the geography, the nature of fraud committed, and more. These models have auto-retrain embedded, which gets triggered when the accuracy falls below an acceptable threshold. We leverage modern machine learning and deep learning algorithms like LSTM (Long short-term memory), Generative Adversarial Networks (GANs), Capsule Network (CapsNets), elastic net, etc., to detect and prevent fraud in the telecom network.


See how Insurance Fraud Management can help your organization
Multi-Channel User Experience
A seamless multi-channel user experience for onboarding on web and mobile application
Cross-Industry Expertise
Leverage our domain expertise across multiple verticals
Improved Profitability
Early detection of fraudulent activities and onboarding the right customers ensures the financial integrity and reputation of your organisation remain intact
Improved Efficiency
Our hybrid solutioning approach ensures maximum coverage, precision, and minimum false positives
Driving Innovative Decision-Making

By providing visibility into your data lineage, uncovering hidden trends, and understanding individual predictions made by Explainable AI, our solution will help you drive innovative decision making

See how Insurance Fraud Management can help your organization
Multi-Channel User Experience
A seamless multi-channel user experience for onboarding on web and mobile application
Cross-Industry Expertise
Leverage our domain expertise across multiple verticals
Improved Efficiency
Our hybrid solutioning approach ensures maximum coverage, precision, and minimum false positives
Driving Innovative Decision-Making

By providing visibility into your data lineage, uncovering hidden trends, and understanding individual predictions made by Explainable AI, our solution will help you drive innovative decision making

Improved Profitability
Early detection of fraudulent activities and onboarding the right customers ensures the financial integrity and reputation of your organisation remain intact

Check out Insurance Fraud Management features

Advanced Machine Learning
Supervised and unsupervised models for continuous feedback and automatic actioning
Hybrid Rule Engine
Advanced rule engine covering detection techniques such as threshold, expressions, and trends
Advanced Document Recognition
Ability to automatically scan and extract data from onboarding documents
Advanced Facial Recognition
Ability to crossmatch facial data from live captured image vs. the image in the document
Location Verification
Ability to correlate the address scanned from the document against the live location captured from the user
Next Generation Fraud Analytics Engine
Ability to carry various types of fraud checks on onboarding data to detect and block fraudulent onboarding in real-time
Computer Vision
Advanced Liveliness detection by leveraging video analytics
Resource center
AI based Risk Intelligence
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