Datamatics developed and successfully implemented a Fraud Analytics solution using the latest mathematical models to curb financial loss due to fraudulent claims for a leading Global Healthcare Insurance Company. The solution also helped the insurance company to avoid reputational loss by resolving the impediments in the processing of non-fraudulent claims. The solution spanned all geographies including UK, Australia, New Zealand, Spain, Asia, and Latin America.
The solution offered a major business success in terms of processing 3.3 million claims in real-time while detecting 65 thousand fraudulent cases with very high accuracy. It also enabled the company to define new markers, which they were unaware about. It resulted in improvement of True Positives and lowering False Positives. The solution efficacy was 80% as compared to conventional methods with error lesser than 8%.