Case study: Detection of Fraud Claims for a Global Leader | P&C Insurance

Business Context

The client, one of the world’s largest property and casualty insurance companies with a presence in multiple geographies has been a strategic analytics partner of BRIDGEi2i globally to drive AI-powered transformation across various business functions. For its claim settlements under “Workers’ Compensation” policies, it wanted to proactively detect fraud and prevent unethical collusion that may give rise to such spurious claims in the future.

How BRIDGEi2i Delivered Value?

Leveraging BRIDGEi2i’s Claims Fraud Management™ Solution, we helped identify various incremental patterns around fraudulent claims with greater accuracy. The associated Machine Learning algorithms took into consideration not only different structured data but also leveraged incremental new data sources with unstructured information such as text information in the form of loss description and document images. By combining the right mix of Data Engineering, NLP and making it available via a web-based user interface/ application allowed an interactive User Interface to view all fraud alerts triggered from the solution’s AI engine as well as view the reason for such alert.

The client reported a 30% increase in fraud capture rates after implementing the solution.

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