Pandemic underscores growing need for anti-fraud technology
CARY, N.C., Nov. 16, 2020 /PRNewswire/ -- As the global coronavirus pandemic rages on, another costly pandemic has taken shape. According to the Association of Certified Fraud Examiners (ACFE), 77% of members surveyed reported increasing levels of fraud amid COVID-19 disruption, one-third of them describing it as significant – and 92% expect it to climb further still.
SAS, the leader in analytics, joins the ACFE in spotlighting International Fraud Awareness Week, Nov. 15-21. Now in its 20th year, Fraud Week is a call for all organizations to fight fraud with awareness and education. The week's opportunities to engage and learn about fraud prevention include:
Government agency cracks down on insurance fraud
Built on SAS® Viya®, the Insurance Crimes Investigation System (ICIS) launched in March. It is the central investigational hub for the DOI's investigators, from initial evidence intake and case development through prosecution and beyond. Algorithms replaced manual processes, helping filter and categorize data, assign resources and facilitate workflows, and even build cases.
According to Frank Rodriguez, Deputy Commissioner of the DOI's Criminal Investigation Division, the ICIS has improved case management efficiency 90%, while the number of insurance fraud related arrests has doubled.
AI-powered chatbot to help victims of identity crimes
Using AI technology including natural language processing, SAS has developed ViViAN, short for Virtual Victim Assistance Network, in collaboration with the ITRC. Now in beta testing for an early 2021 launch, ViViAN is intended to be a client's first line of communication with the ITRC, helping staff minimize wait times and assist more people. The non-profit has seen a steep rise in contact volume around unemployment benefits identity theft, from fewer than 20 reports in 2019 to nearly 750 in 2020 through October.
"Behind every instance of fraud is a human victim," said ITRC President and CEO, Eva Velasquez. "ViViAN will provide an invaluable lifeline to victims of such crimes, helping them find the resources they need at any hour of the day or night, whenever they need it most."
Insurance consortium curbs claims fraud with AI and analytics
SAS® Detection and Investigation for Insurance uses multiple techniques, including advanced analytics with embedded AI and machine learning. Through these capabilities, FenSeg gained the ability to score claims in real time and a visual interface for spotting linked entities and crime rings it may have otherwise missed. The platform has brought more suspicious claims to light through a speedier, automated process while increasing alerts by 286%.
"But the key to fraud prevention isn't just more alerts – it's more accurate alerts that insurers can act on," said Ricardo Pereira, Insurance Fraud Prevention and Combat Manager at CNseg. "I'm pleased to say that the number of suspicious claims that proved to be fraudulent has increased 67%, thanks to SAS' fraud detection solution."
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