Fraud Detection, Analytics and Pattern Analysis for Insurance

Complete Guide to Fraud Detection Techniques in Insurance

 

The Three Major Challenges For Insurance Industry –

 

  • More Insights from Existing Data.
  • Adding New Sources of Data into Existing Models.
  • Building Real-Time Decision Analytics Platform for Predictive and Prescriptive Analytics.

 

Actuarial and Underwriting Analytics

 

Predictive Modeling used for actuarial and underwriting analytics. It is a process whereby statistical and analytical techniques identify patterns that are then used to develop models that predict the likelihood of future events or behaviors.

 

Claim Analytics

 

Predictive Modeling is used to improve the claim process and detect fraud and provider payment abuse. Predictive Analytics is used to analyze the data for claims, fraud, and abuse detection.

 

Fraud Analytics

 

Data Mining used to detect fraud through the use of Data Mining Tools quickly. These tools used for tracking millions of transactions to spot patterns and detect fraudulent transaction.

 

Big Data Technologies

 

Big Data Technologies enables Insurance Industry to modernize data systems and data infrastructure to build Real-Time Data Integration and Analytics Platform and integrate data from different data sources like sensors, Images, Videos and other sources for data science-driven predictive and prescriptive analytics for finding customer needs, interests and defining risk-based pricing models and faster claim processing.

 

Business Challenge for Implementing Insurance Analytics

 

  • To implement Insurance Analytics, Fraud Detection, Customer Profiling, and Data Integration on various types of datasets and data sources which consists of PDF, PDF Images, CSV Files, and SQL Server Database.
  • Data Integration platform with functionalities for Machine Learning, Deep Learning and Predictive Analytics using Open Source Technologies, On-Premises and Hybrid Cloud Deployment.
  • For Customer Profiling and Insurance Analytics, require an interactive dashboard for Data Visualization with Python, Flask Framework, Javascript, and D3.JS.

 

Solution Offered for Fraud Detection and Pattern Analysis

 

  • Implement Apache Nifi as Data Ingestion platform to query database processors to fetch data from SQL server database.
  • To detect various fields, develop a custom Apache Nifi processor along with Java OCR.
  • Use Apache Nifi to join data from various data sources.
  • REST API’s and view the joined data on the dashboard in the form of links using D3.JS. Ultimately perform Link Analysis to identify the fraud claimants.
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class="wpforms-field wpforms-field-email col-12 col-sm-12 col-md-12 form-group" data-field-id="2"><label class="wpforms-field-label" for="wpforms-8104-field_2">Email <span class="wpforms-required-label">*</span></label><input type="email" id="wpforms-8104-field_2" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][2]" placeholder="Email" required></div><div id="wpforms-8104-field_3-container" class="wpforms-field wpforms-field-text col-12 col-sm-12 col-md-12 form-group" data-field-id="3"><label class="wpforms-field-label" for="wpforms-8104-field_3">Organization <span class="wpforms-required-label">*</span></label><input type="text" id="wpforms-8104-field_3" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][3]" placeholder="Organization" required></div><div id="wpforms-8104-field_41-container" class="wpforms-field wpforms-field-hidden" data-field-id="41"><input type="hidden" id="wpforms-8104-field_41" name="wpforms[fields][41]" value="Friday - Modernise Data"></div><div id="wpforms-8104-field_11-container" class="wpforms-field wpforms-field-pagebreak" data-field-id="11"><div class="wpforms-clear wpforms-pagebreak-left"></div></div></div></div><div class="wpforms-field wpforms-field-hp"><label for="wpforms-8104-field-hp" class="wpforms-field-label">Email</label><input type="text" name="wpforms[hp]" id="wpforms-8104-field-hp" class="wpforms-field-medium"></div><input type="hidden" name="wpforms[recaptcha]" value=""><div class="wpforms-submit-container" style="display:none;"><input type="hidden" name="wpforms[id]" value="8104"><input type="hidden" name="wpforms[author]" value="3"><input type="hidden" name="wpforms[post_id]" value="887"><button type="submit" name="wpforms[submit]" class="wpforms-submit om-trigger-conversion mon-btn" id="wpforms-submit-8104" value="wpforms-submit" aria-live="assertive" data-alt-text="Submitting..." data-submit-text="Submit">Submit</button></div></form></div> <!-- .wpforms-container -->
[wpforms id="8095"]
<div class="wpforms-container wpforms-container-full optin-monster-forms" id="wpforms-8095"><form id="wpforms-form-8095" class="wpforms-validate wpforms-form" data-formid="8095" method="post" enctype="multipart/form-data" action="/use-cases/insurance-analytics-fraud-detection-ai/" data-token="249e671926a80a17c9260eb5c3b58f44"><noscript class="wpforms-error-noscript">Please enable JavaScript in your browser to complete this form.</noscript><div class="wpforms-page-indicator progress" data-indicator="progress" data-indicator-color="#72b239" data-scroll="1"><span class="wpforms-page-indicator-page-title" ></span><span class="wpforms-page-indicator-page-title-sep" style="display:none;"> - </span><span class="wpforms-page-indicator-steps">Step <span class="wpforms-page-indicator-steps-current">1</span> of 2</span><div class="wpforms-page-indicator-page-progress-wrap"><div class="wpforms-page-indicator-page-progress" style="width:50%;background-color:#72b239;"></div></div></div><div class="wpforms-field-container"><div class="wpforms-page wpforms-page-1 "><div id="wpforms-8095-field_10-container" class="wpforms-field wpforms-field-pagebreak" data-field-id="10"></div><div id="wpforms-8095-field_24-container" class="wpforms-field wpforms-field-html form-popup-header-wrapper" data-field-id="24"><div id="wpforms-8095-field_24"><div class="form-popup-header"> <h2>RPA and Cognitive Automation</h2> <p>Making business processes smarter and more efficient</p> </div></div></div><div id="wpforms-8095-field_21-container" class="wpforms-field wpforms-field-radio custom-radio-btn-wrapper wpforms-list-3-columns" data-field-id="21"><label class="wpforms-field-label wpforms-label-hide" for="wpforms-8095-field_21">Sevices <span class="wpforms-required-label">*</span></label><ul id="wpforms-8095-field_21" class="wpforms-field-required wpforms-image-choices wpforms-image-choices-modern"><li class="choice-1 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8095-field_21_1" tabindex="0"><span class="wpforms-image-choices-image"><img src="https://www.xenonstack.com/wp-content/uploads/2020/07/automation-anywhere.png" alt=""></span><input type="radio" id="wpforms-8095-field_21_1" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Choice 1" tabindex="-1" required ><span class="wpforms-image-choices-label"></span></label></li><li class="choice-2 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8095-field_21_2" tabindex="0"><span class="wpforms-image-choices-image"><img src="https://www.xenonstack.com/wp-content/uploads/2020/07/uipath.png" alt=""></span><input type="radio" id="wpforms-8095-field_21_2" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Choice 2" tabindex="-1" required ><span class="wpforms-image-choices-label"></span></label></li><li class="choice-3 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8095-field_21_3" tabindex="0"><span class="wpforms-image-choices-image"><img src="https://www.xenonstack.com/wp-content/uploads/2020/07/blueprism.png" alt=""></span><input type="radio" id="wpforms-8095-field_21_3" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Choice 3" tabindex="-1" required ><span class="wpforms-image-choices-label"></span></label></li><li class="choice-4 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8095-field_21_4" tabindex="0"><input type="radio" id="wpforms-8095-field_21_4" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Intelligent Automation" tabindex="-1" required ><span class="wpforms-image-choices-label">Intelligent Automation</span></label></li><li class="choice-5 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8095-field_21_5" tabindex="0"><input type="radio" id="wpforms-8095-field_21_5" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="RPA with AI" tabindex="-1" required ><span class="wpforms-image-choices-label">RPA with AI</span></label></li><li class="choice-6 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8095-field_21_6" tabindex="0"><input type="radio" id="wpforms-8095-field_21_6" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Open Source RPA Implementation" tabindex="-1" required ><span class="wpforms-image-choices-label">Open Source RPA Implementation</span></label></li></ul></div><div id="wpforms-8095-field_23-container" class="wpforms-field wpforms-field-pagebreak" data-field-id="23"><div class="wpforms-clear wpforms-pagebreak-left"><button class="wpforms-page-button wpforms-page-next" data-action="next" data-page="1" data-formid="8095">Next</button></div></div></div><div class="wpforms-page wpforms-page-2 last " style="display:none;"><div id="wpforms-8095-field_25-container" class="wpforms-field wpforms-field-html form-popup-header-wrapper" data-field-id="25"><div id="wpforms-8095-field_25"><div class="form-popup-header"> <h2>Let Us Discuss and Understand the Requirement</h2> </div></div></div><div id="wpforms-8095-field_20-container" class="wpforms-field wpforms-field-name col-12 col-sm-12 col-md-12 form-group" data-field-id="20"><label class="wpforms-field-label" for="wpforms-8095-field_20">Name <span class="wpforms-required-label">*</span></label><input type="text" id="wpforms-8095-field_20" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][20]" placeholder="Name" required></div><div id="wpforms-8095-field_2-container" class="wpforms-field wpforms-field-email col-12 col-sm-12 col-md-12 form-group" data-field-id="2"><label class="wpforms-field-label" for="wpforms-8095-field_2">Email <span class="wpforms-required-label">*</span></label><input type="email" id="wpforms-8095-field_2" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][2]" placeholder="Email" required></div><div id="wpforms-8095-field_3-container" class="wpforms-field wpforms-field-text col-12 col-sm-12 col-md-12 form-group" data-field-id="3"><label class="wpforms-field-label" for="wpforms-8095-field_3">Organization <span class="wpforms-required-label">*</span></label><input type="text" id="wpforms-8095-field_3" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][3]" placeholder="Organization" required></div><div id="wpforms-8095-field_41-container" class="wpforms-field wpforms-field-hidden" data-field-id="41"><input type="hidden" id="wpforms-8095-field_41" name="wpforms[fields][41]" value="Thrusday RPA Form"></div><div id="wpforms-8095-field_11-container" class="wpforms-field wpforms-field-pagebreak" data-field-id="11"><div class="wpforms-clear wpforms-pagebreak-left"></div></div></div></div><div class="wpforms-field wpforms-field-hp"><label for="wpforms-8095-field-hp" class="wpforms-field-label">Website</label><input type="text" name="wpforms[hp]" id="wpforms-8095-field-hp" class="wpforms-field-medium"></div><input type="hidden" name="wpforms[recaptcha]" value=""><div class="wpforms-submit-container" style="display:none;"><input type="hidden" name="wpforms[id]" value="8095"><input type="hidden" name="wpforms[author]" value="3"><input type="hidden" name="wpforms[post_id]" value="887"><button type="submit" name="wpforms[submit]" class="wpforms-submit om-trigger-conversion mon-btn" id="wpforms-submit-8095" value="wpforms-submit" aria-live="assertive" data-alt-text="Submitting..." data-submit-text="Submit">Submit</button></div></form></div> <!-- .wpforms-container -->
[wpforms id="8085"]
<div class="wpforms-container wpforms-container-full optin-monster-forms" id="wpforms-8085"><form id="wpforms-form-8085" class="wpforms-validate wpforms-form" data-formid="8085" method="post" enctype="multipart/form-data" action="/use-cases/insurance-analytics-fraud-detection-ai/" data-token="249e671926a80a17c9260eb5c3b58f44"><noscript class="wpforms-error-noscript">Please enable JavaScript in your browser to complete this form.</noscript><div class="wpforms-page-indicator progress" data-indicator="progress" data-indicator-color="#72b239" data-scroll="1"><span class="wpforms-page-indicator-page-title" ></span><span class="wpforms-page-indicator-page-title-sep" style="display:none;"> - </span><span class="wpforms-page-indicator-steps">Step <span class="wpforms-page-indicator-steps-current">1</span> of 2</span><div class="wpforms-page-indicator-page-progress-wrap"><div class="wpforms-page-indicator-page-progress" style="width:50%;background-color:#72b239;"></div></div></div><div class="wpforms-field-container"><div class="wpforms-page wpforms-page-1 "><div id="wpforms-8085-field_10-container" class="wpforms-field wpforms-field-pagebreak" data-field-id="10"></div><div id="wpforms-8085-field_24-container" class="wpforms-field wpforms-field-html form-popup-header-wrapper" data-field-id="24"><div id="wpforms-8085-field_24"><div class="form-popup-header"> <img src="https://www.xenonstack.com/images/wednesday-digitally-transform-popup-img.png" /> <h2>Digitally Transform <span>your Organization </span></h2> </div></div></div><div id="wpforms-8085-field_21-container" class="wpforms-field wpforms-field-radio custom-radio-btn-wrapper wpforms-list-2-columns" data-field-id="21"><label class="wpforms-field-label wpforms-label-hide" for="wpforms-8085-field_21">Sevices <span class="wpforms-required-label">*</span></label><ul id="wpforms-8085-field_21" class="wpforms-field-required wpforms-image-choices wpforms-image-choices-modern"><li class="choice-1 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8085-field_21_1" tabindex="0"><span class="wpforms-image-choices-image"><img src="https://www.xenonstack.com/wp-content/uploads/2020/07/continous-delivery-e1594278564177.png" alt="Continous Delivery and DevSecOps" title="Continous Delivery and DevSecOps"></span><input type="radio" id="wpforms-8085-field_21_1" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Continous Delivery and DevSecOps" tabindex="-1" required ><span class="wpforms-image-choices-label">Continous Delivery and DevSecOps</span></label></li><li class="choice-2 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8085-field_21_2" tabindex="0"><span class="wpforms-image-choices-image"><img src="https://www.xenonstack.com/wp-content/uploads/2020/07/robotic-process.png" alt="Robotic Process Automation" title="Robotic Process Automation"></span><input type="radio" id="wpforms-8085-field_21_2" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Robotic Process Automation" tabindex="-1" required ><span class="wpforms-image-choices-label">Robotic Process Automation</span></label></li><li class="choice-3 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8085-field_21_3" tabindex="0"><span class="wpforms-image-choices-image"><img src="https://www.xenonstack.com/wp-content/uploads/2020/07/big-data-analytics.png" alt="Big Data Analytics" title="Big Data Analytics"></span><input type="radio" id="wpforms-8085-field_21_3" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Big Data Analytics" tabindex="-1" required ><span class="wpforms-image-choices-label">Big Data Analytics</span></label></li><li class="choice-4 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8085-field_21_4" tabindex="0"><span class="wpforms-image-choices-image"><img src="https://www.xenonstack.com/wp-content/uploads/2020/07/cloud-security.png" alt="Cloud Security" title="Cloud Security"></span><input type="radio" id="wpforms-8085-field_21_4" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Cloud Security" tabindex="-1" required ><span class="wpforms-image-choices-label">Cloud Security</span></label></li><li class="choice-5 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8085-field_21_5" tabindex="0"><span class="wpforms-image-choices-image"><img src="https://www.xenonstack.com/wp-content/uploads/2020/07/data-science-ai.png" alt="Data Science and AI" title="Data Science and AI"></span><input type="radio" id="wpforms-8085-field_21_5" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Data Science and AI" tabindex="-1" required ><span class="wpforms-image-choices-label">Data Science and AI</span></label></li><li class="choice-6 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" for="wpforms-8085-field_21_6" tabindex="0"><span class="wpforms-image-choices-image"><img src="https://www.xenonstack.com/wp-content/uploads/2020/07/cloud-migration.png" alt="Cloud Migration" title="Cloud Migration"></span><input type="radio" id="wpforms-8085-field_21_6" class="wpforms-screen-reader-element" name="wpforms[fields][21]" value="Cloud Migration" tabindex="-1" required ><span class="wpforms-image-choices-label">Cloud Migration</span></label></li></ul></div><div id="wpforms-8085-field_23-container" class="wpforms-field wpforms-field-pagebreak" data-field-id="23"><div class="wpforms-clear wpforms-pagebreak-left"><button class="wpforms-page-button wpforms-page-next" data-action="next" data-page="1" data-formid="8085">Next</button></div></div></div><div class="wpforms-page wpforms-page-2 last " style="display:none;"><div id="wpforms-8085-field_25-container" class="wpforms-field wpforms-field-html form-popup-header-wrapper" data-field-id="25"><div id="wpforms-8085-field_25"><div class="form-popup-header"> <img src="https://www.xenonstack.com/images/wednesday-digitally-transform-popup-img.png" /> <div> <h2>How can we get in Touch</h2> <p>Fill the form and we will revert back to you soon.<p></div> </div></div></div><div id="wpforms-8085-field_20-container" class="wpforms-field wpforms-field-name col-12 col-sm-12 col-md-12 form-group" data-field-id="20"><label class="wpforms-field-label" for="wpforms-8085-field_20">Name <span class="wpforms-required-label">*</span></label><input type="text" id="wpforms-8085-field_20" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][20]" placeholder="Name" required></div><div id="wpforms-8085-field_2-container" class="wpforms-field wpforms-field-email col-12 col-sm-12 col-md-12 form-group" data-field-id="2"><label class="wpforms-field-label" for="wpforms-8085-field_2">Email <span class="wpforms-required-label">*</span></label><input type="email" id="wpforms-8085-field_2" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][2]" placeholder="Email" required></div><div id="wpforms-8085-field_3-container" class="wpforms-field wpforms-field-text col-12 col-sm-12 col-md-12 form-group" data-field-id="3"><label class="wpforms-field-label" for="wpforms-8085-field_3">Organization <span class="wpforms-required-label">*</span></label><input type="text" id="wpforms-8085-field_3" class="wpforms-field-large wpforms-field-required" name="wpforms[fields][3]" placeholder="Organization" required></div><div id="wpforms-8085-field_41-container" class="wpforms-field wpforms-field-hidden" data-field-id="41"><input type="hidden" id="wpforms-8085-field_41" name="wpforms[fields][41]" value="Wednesday Generic form"></div><div id="wpforms-8085-field_11-container" class="wpforms-field wpforms-field-pagebreak" data-field-id="11"><div class="wpforms-clear wpforms-pagebreak-left"></div></div></div></div><div class="wpforms-field wpforms-field-hp"><label for="wpforms-8085-field-hp" class="wpforms-field-label">Website</label><input type="text" name="wpforms[hp]" id="wpforms-8085-field-hp" class="wpforms-field-medium"></div><input type="hidden" name="wpforms[recaptcha]" value=""><div class="wpforms-submit-container" style="display:none;"><input type="hidden" name="wpforms[id]" value="8085"><input type="hidden" name="wpforms[author]" value="3"><input type="hidden" name="wpforms[post_id]" value="887"><button type="submit" name="wpforms[submit]" class="wpforms-submit om-trigger-conversion mon-btn" id="wpforms-submit-8085" value="wpforms-submit" aria-live="assertive" data-alt-text="Submitting..." data-submit-text="Submit">Submit</button></div></form></div> <!-- .wpforms-container -->
[wpforms id="8051"]
<div class="wpforms-container wpforms-container-full optin-monster-forms" id="wpforms-8051"><form id="wpforms-form-8051" class="wpforms-validate wpforms-form" data-formid="8051" method="post" enctype="multipart/form-data" action="/use-cases/insurance-analytics-fraud-detection-ai/" data-token="249e671926a80a17c9260eb5c3b58f44"><noscript class="wpforms-error-noscript">Please enable JavaScript in your browser to complete this form.</noscript><div class="wpforms-page-indicator progress" data-indicator="progress" data-indicator-color="#72b239" data-scroll="1"><span class="wpforms-page-indicator-page-title" ></span><span class="wpforms-page-indicator-page-title-sep" style="display:none;"> - </span><span class="wpforms-page-indicator-steps">Step <span class="wpforms-page-indicator-steps-current">1</span> of 2</span><div class="wpforms-page-indicator-page-progress-wrap"><div class="wpforms-page-indicator-page-progress" style="width:50%;background-color:#72b239;"></div></div></div><div class="wpforms-field-container"><div class="wpforms-page wpforms-page-1 "><div id="wpforms-8051-field_10-container" class="wpforms-field wpforms-field-pagebreak" data-field-id="10"></div><div id="wpforms-8051-field_24-container" class="wpforms-field wpforms-field-html form-popup-header-wrapper" data-field-id="24"><div id="wpforms-8051-field_24"><div class="form-popup-header"> <h2>Build an AI-Driven Enterprise</h2> <p>Unlock the potential of AI at scale</p> </div></div></div><div id="wpforms-8051-field_21-container" class="wpforms-field wpforms-field-radio custom-radio-btn-wrapper wpforms-list-3-columns" data-field-id="21"><label class="wpforms-field-label wpforms-label-hide" for="wpforms-8051-field_21">Sevices <span class="wpforms-required-label">*</span></label><ul id="wpforms-8051-field_21" class="wpforms-field-required wpforms-image-choices wpforms-image-choices-modern"><li class="choice-1 depth-1 wpforms-image-choices-item"><label class="wpforms-field-label-inline" 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