Asseco FDS-I
Fraud Detection System for Insurance

Increase the effectiveness of insurance fraud detection and reduce financial losses.

Asseco FDS-I - increased efficiency in the fight against insurance fraud.

The system is monitoring and verifying the claim reports already at the moment of their registration. It identifies and marks claims, that may be fraudulent. In this way, it facilitates the tasks of anti-fraud teams, which can focus on an in-depth analysis of the cases selected by Asseco FDS-I.
Asseco Fraud Detection System for Insurance (Asseco FDS-I) - an operating tool for insurance companies that enables automatic classification of claims and detection of fraud at every stage of claim settlement, as well as during the sale process. Asseco FDS-I increases the effectiveness of fraud detection and reduces financial losses caused by undue payments.

Main benefits

Asseco FDS-I

Fast and successful.

Based on parametrized rules, Asseco FDS-I is monitoring all claims in real time, from the stage of their registration. They are automatically categorized online to:

– secure claims, that can be routed to a simplified path,

– suspect claims, that can be immediately forwarded to the anti-fraud team,

– other claims, that are handled on a standard path.

As claims’ data is updated, e.g. with information from an expert, the system automatically reclassifies the claims, which allows a change of the procedure path.

Accurate and comprehensive.

The system uses current and historical data of incidents, which are obtained from the insurance company’s claims database, from the Insurance Guarantee Fund (UFG) and from the Integrated Platform for Identification and Verification of Insurance Crime Phenomena (ZPIiWZPU). It analyses collected information and relations between the entities (e.g. injured party, perpetrator, driver) and objects (e.g. vehicles) participating in the incident. In this way the system effectively identifies the fraud symptoms and possible connections, what allows a better fraud detection.

Asseco FDS-I
Asseco FDS-I

Flexible and up-to-date.

Asseco FDS-I was built in a way that enables insurance companies to easily adapt the system to changing types of threats in the insurance area. This allows them to react quickly to the emergence of a new fraud schemes.

The system enables users to create expert rules, defined in the form of expressions or decision boards. It also allows to use analytical models, available in the form of services, e.g. created using Machine Learning and AI tools.

Effective and efficient.

The FDS-I module has been equipped with a dashboard – a set of basic reports, allowing for the ongoing evaluation of the system’s performance. They provide, among other things, data on the stream and distribution of claims in particular segments, the amount of damage directed to specific paths, as well as the effectiveness of scoring algorithms and rules. Based on that, the administrator can easily adjust the system to the current needs of loss adjusters and anti-fraud team.

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Bet on the efficient fraud detection!

Scoring engine.

The system has an effective scoring engine running in real-time, equipped with a two-level parameterization mechanism:
- Graphical rule editor - it allows you to create new rules, which enables you to react quickly to prevent new forms of fraudulent behavior,
- Graphical editor of numerical parameters and thresholds - allows you to instantly adjust numerical parameters, which ensures efficient control of the losses’ stream directed to particular paths.

Data sources

Scoring is based on a wide spectrum of diverse information sources. By default, the input data are:
- data about the incident collected during claim registration,
- additional information registered by loss adjusters and experts in the loss adjustment process,
- historical data about the policy and damages for all entities and objects related to the incident from the insurer's database,
- for communication damages additionally: - data about the insurance history of individuals and vehicles participating in the incident from the OI UFG database - policy and damage scoring from the ZPIiWZPU service.

Integration

Asseco FDS-I communicates with the claims' system via API, which invokes the FDS-I module service, providing the claim’s data. In response, the user receives a calculated scoring value along with the claim assigned to a specific segment.
The API function is also made available for the purposes of integration with the sales system, which enables the analysis of policy's applications for detecting suspicious situations.

FDS-I - protects those who insure!

The system increases the effectiveness of the organization's operations, and its flexibility and parameterization capabilities enable quick adjustment to new fraud schemes and organization requirements.