Technology

Insurance fraud and claims leakage are a concerning issue for all insurers globally including those in the Middle East. PwCs (PricewaterhouseCoopers) 2014 Middle East Economic Crime Survey revealed that only 5% of frauds were detected by internal audit, with 22% detected by tip-offs and 16% now detected by chance, indicating a widespread lack of effective fraud detection methods in the region.

To provide fraud analytics more quickly and affordably, SAS is now offering SAS Fraud Framework for Insurance via the cloud to insurance companies in the Middle East. This new option not only increases investigator efficiency and lowers cost of ownership, but does it securely on the SAS Cloud as a software-as-a-service (SaaS) offering.

With over 50 years of experience in the Insurance Fraud sector, we at SAS helped develop fraud solutions for a number of organizations ranging from Motor, Home, Health Insurance including Workers Compensation among others.

The exact rates of claims fraud, waste and abuse are difficult to determine but recent figures from regional industry and regulatory bodies suggests that figures allude to the notion that as much as 10% of claims are fraudulent and as little as 20% of these are detected, and global figures range from 5% to 15%, said Ebru Jouzy, Fraud and AML (Anti Money Laundering) expert, Middle East and Turkey at SAS.

SAS Fraud Framework for Insurance helps more accurately detect potentially fraudulent activity with the solution being flexible if any new rules need to be added as new fraud types evolve. The pre-built fraud analytical models are enabled companies to implement the solution in weeks instead of months. Powered by SAS advanced fraud analytics engine, SAS Fraud Framework for Insurance uses multiple analytics techniques: business rules, anomaly detection, predictive modelling, database searches and link analysis. The solution enables insurers to uncover more suspicious activity than traditional manual methods of detection.

Combating claims fraud is difficult and costly for insurers but not for organized crime rings, which find insurance fraud to be a low-risk, high-return enterprise. With this in mind, it is important for insurance companies to have a defense mechanism that helps them to manage, detect and predict potentially suspicious claims before further losses are incurred. added Jouzy.

Analysts across industries point to a continued shift of IT budgets away from in-house installations to cloud-based delivery models. CEB TowerGroup USA research shows that 59% of insurance firms expect increased spending on cloud solutions technology over the next few years.

Meanwhile, recognizing the importance of tackling claims fraud, US-based Grange Insurance that offers auto, home, life and business insurance protection to its policyholders wanted to implement a solution quickly. In opting for a cloud-based fraud detection solution, Grange was able to make SAS Fraud Framework for Insurance available in weeks. In addition, companies also prefer onsite installations due to their internal policies and SAS provides the best-fit on-site and cloud solution options for its customers.

Learn more about SAS Fraud Framework for Insurance via the cloud or on-site to detect suspicious claims activity and organized fraud rings.

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