India's largest platform and marketplace for AI & Analytics leaders & professionals

Sign in

India's largest platform and marketplace for AI & Analytics leaders & professionals

3AI Digital Library

Claims Fraud Detection for Auto Insurer

3AI August 15, 2020

Leading Auto Insurer in India

Problem Statement

  • A scenario of an estimated 3% fraudulent/improper claims against an industry average of 1%.
  • Objective was to enhance the upstream fraud detection capabilities not only at the claims level but also at the customer level

Analytics Led Approach

  • Broad process steps which were followed :
    • Sensitive data encryption
    • Load the data from
    • multiple sources Logistic Regression Model creation
    • Data cleansing ; Data transformation; Business Significant variables deduction
    • Distribution analysis
    • Correlation analysis
    • Multi- dimensional Analysis
    • Fraud analysis through data profiling
    • Identify key suspect indicators which indicated possible provider frauds

Business Impact

  • A proof of concept wherein Customers’ auto claims data for specific calendar year were analyzed and trends and patterns from analysis were presented to the business team
  • Claims fraud detection helped to identify the potential losses due to fraud or suspect claims and thereby helped to reduce claims leakage to a great extent

Critical Success Factors

  • Significant reduction in false positive
  • 3.5% of 2010 claims identified as potential fraud
  • 26 Crores of potential losses due to fraud

    3AI Trending Articles

  • European Union to revamp Cybersecurity rules

    EU last year recorded around 450 cyber incidents involving European infrastructure, notably in the financial and energy sectors, and the pandemic has highlighted Europe’s deep dependence on the internet and exposed security weaknesses.  The European Union unveiled Wednesday plans to revamp the 27-nation bloc’s dated cybersecurity rules, just days after data on a new coronavirus vaccine was unlawfully accessed in […]

  • Combining the power of Generative & Predictive AI

    Featured Article: Author: Shuvajit Basu GenAI has taken the world by storm. I certainly don’t have to outline the numerous possibilities it brings to bear. Both GenAI and Predictive AI have their share of strengths andbopportunities. However, if we can combine the power of these Generative models with Predictive AI/ML models, we might be able […]

  • Transformation of Talent Acquisition by Algorithms

    Business leaders have long recognized that the ability to hire the right talent plays a significant role in any organization’s performance. Views about the challenges to acquiring and retaining such talent have evolved over time. We have moved on from a focus on the notion that a talent shortage is creating a “war for talent,” an […]

  • Salesforce embraces the public cloud with Hyperforce

    Salesforce is letting CIOs choose where they run its software, easing compliance with data protection and data sovereignty laws. Salesforce.com President and COO Bret Taylor believes the SaaS vendor has made “probably the most significant technological shift” since its CRM platform first launched 21 years ago. But Taylor wasn’t talking about the company’s agreement to acquire […]