Fraud is an industry-wide problem that now accounts for nearly 40% of all crime. According to the Association of British Insurers, fraudulent claims in the UK contribute an extra £50 to a policyholder’s coverage each year. In order to combat this, Aioi Nissay Dowa Insurance UK (ANDE-UK) used a rule-based model to automatically flag and triage a subset of claims for further human investigation. Though this saved many hours, the number of cases sent to triage remained high, the model performance deteriorated over time, and the lack of explainability made it nearly impossible for investigators to budget their time and know what to investigate first.
In a highly competitive market, the impact of fraud on AND-E UK's business added an unwanted £50 to the premiums of policyholders each year.
Mind Foundry worked closely with AND-E to understand the telltale signs of fraud from a human perspective and embed that into a three-pronged AI solution they could collaborate with to combat fraud more intelligently.
The solution incorporated more diverse datasets into a continuously learning model, significantly improving the quality of cases sent to triage and adapting to new fraud cases.
It prioritised flagged claims in an investigation dashboard, so AND-E UK could resolve them in order of the likelihood that they contained actual instances of fraud.
It accelerated the investigator’s ability to generate reports and close cases with natural language search options for structured and unstructured data, including hand-written notes and phone numbers.
The Fraud Detection Solution has collaboration at its heart and enables both humans and machines to learn from each other. AND-E UK and Mind Foundry’s program has increased referrals retained by the fraud department from 2% to 18%, meaning that handlers work on much fewer false positive cases. As a result, the detection of fraudulent claims has increased by 120% compared to the legacy system.
The impact of the collaboration goes beyond AND-E UK and Mind Foundry. Correctly detecting fraudulent data also has an extremely positive impact on the insurance industry at a national level. The model’s results are contributed to a national fraud database, which is used by insurers across the country to better inform their fraud identification processes.
Mind Foundry’s fraud solution enabled AND-E to improve fraud detection by 120% within the first month of adoption, compared to our traditional system. We expect this to continue improving as the model continuously learns and we expand our partnership. This is hugely beneficial to both AND-E and our customers, helping us to eliminate more fraudsters and become more competitive by reducing the cost of fraud being passed onto our customers, which averages at around £50 per premium.
Chief Underwriting Officer
Aioi Nissay Dowa Insurance
Watch the video below to learn how Mind Foundry are helping Aioi Nissay Dowa Insurance Europe (AND-E) transform their fraud investigations.
To find out more about our work with AND-E you can watch the entire webinar here.
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