BayesFraud

BayesFraud is a market-leading predictive analytics solution that provides insurers with advanced, automated fraud detection capabilities during claims handling.

Our solution consistently evaluates all submitted claims for fraud and alerts claims handlers to high-risk claims. In this way routine claims can be fast-tracked for immediate settlement, and claims with the highest likelihood of fraud can be investigated further – before costly claims are paid out.

The results: A positive end-to-end claims experience strengthens customer loyalty and retention. And when only high-risk claims are sent to investigators, hit-rate accuracy increases and valuable time and resources can be dedicated to claims with the greatest potential of fraud – and cost savings for insurers.

It combines claims data with the incredibly valuable input from claims and fraud experts in one and the same model

It quantifies missing and uncertain data and observations, to “fill in the data holes” in claims data Calculates fraud on the basis of every shred of evidence available

Uncovers insight about fraud patterns and relationships that would otherwise be missed using manual or rules-based processes

Learns from data as more claims data and information become available

Powered by the proprietary algorithms of the HUGIN Decision Engine, BayesFraud produces extremely accurate fraud predictions, and provides insurers with the optimal foundation for identifying fraud.

BayesFraud is an add-on system that integrates into an insurer’s claims IT, either as a batch system for periodic fraud screening, or as a real-time warning system that computes fraud probability during claims handling.

Here real-time BayesFraud is integrated as a traffic light on the screens of claims handlers:

Early, consistent evaluation of all claims

Calculates fraud probability in real-time

Combines data with input from fraud experts

Handles uncertainty and missing observations

Can be customized to specific business profile and needs

Model solution is easy to integrate

Adjustments and changes can be