Insurance Fraud Management

One-stop solution to address all types of frauds across insurance services.

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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.

Onboarding Risk assessment

Insurance Claim Fraud Detection

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