INSURANCE INFORMATION AND MONITORING CENTER AYDIN SATICI Managing Director April 2015 Sigorta Bilgi ve Gözetim Merkezi
1. 2. Mobile Accident Report Application 3. Fraud Management System and Social Network Analysis
Board of Directors 3 CEOs 1 Rep. of Treasury 1 Rep. of Association None Profit Organization IT Company of Insurance Sector Data WareHouse Company Center of DATA
Insurance in Figure Turkiye s Annual Premium Volume 10 Billion Dollars Risks Undertaken 20 Trillion Dollars -240.000.000 TL +240.000.000 TL
IIC (SBM) FIGURES Employees 100 Transactions Policies 300 3 Billions / year Claims Millions Figure s 30 Millions Registered End Users 80,000 Insurance Companies 65 Agents 15,000 Insurance Experts 1,800 Revenue 5 Millions Public Dollars Users Millions of Citizens
The World s First and Unique and Best Mobile Accident Report Dünya nın ilk Mobil Kaza Tutanağı Uygulaması
TAKE PHOTO LOCATION CODE Mobile Accident Report FIRST AND UNIQUE IN THE WORLD READ QR CODE TELL ACCIDENT CRASH POINT SIGN and SEND IN METROPOLS like İSTANBUL and ANKARA STOP TRAFFIC JAM! Time of Entry BEFORE AFTER 10min 100min No Paper No Pen No Mailing No Fraud No Wait No Traffic Jam No Waste of Time
SAVING OF TIME 13days Decision Period 3day s FIRST AND UNIQUE IN THE WORLD SİGORTA ŞİRKETİNE ANINDA BİLDİRİM! Mobile Accident Report USAGE AREA 19 million vehicles 25 million drivers 35 million smart phones 37 traffic accident every seconds In Turkiye REAL TIME TRACKING ON THE MAP
Insurance FRAUD LANDSCAPE Claims Exaggeration Deliberate Fraudsters Criminal Gangs Small ticket = discourage Areas to pass to investigate $ VALUE 60% 40%
THE CLAIMS FRAUD LANDSCAPE Claims Exaggeration Deliberate Fraudsters Criminal Gangs Role of Individual insurer
Cross Carrier Fraud Role of IIC (sbm) To seek out organised criminal gangs who are deliberately targeting many insurers To provide a view of data that one insurer on their own cannot see Claim A Claim B Claim C To work with the affected insurers to address this network
Cross Carrier Fraud Role of IIC (sbm) This individual is linked to 2 claims with 2 different insurers This individual is linked to 2 claims with 2 different insurers This garage is linked to 2 claims with 2 different insurers This vehicle is linked to 2 claims with 2 different insurers
Claims Policies Claimant Fraud Data Staging Data mining techniques Push Alerts to the right investigator Rank Alerts based risk score Create suspicious reports Close alerts as true / false Activity reports Intelligent Fraud Repository Data Management - Select Data - Collect Data - Clean data - Prepare data for analysis Modeling - Use statistical methods to model known fraudulent cases - Use exploratory analysis to discover new fraudulent patterns Alert Detection - Execute on a regular basis fraud scenario to detect anomaly - Produce alerts to be investigated by field Case Initiation & Investigation - Use all available data to analyze suspicious cases - Web local interface for investigation Reporting - Store every single fraud cases as well as results of analyze to improve system - Follow-up of global fraud activity To handle the whole fraud process, for an end-to-end use or to complete current fraud systems SAS Fraud Framework for insurance
SAS Fraud Framework A variety of techniques PM: Build a fraud factor into final rating price Complex Patterns Unstructured Patterns AD: Detect Unknown patterns Patternsof new applications Anomaly Detection Predictive Modeling Text Mining Database Searches DS: Checking against internal or external Known Fraud watch lists Can be at household level ABR: Checking Known Patterns against history of proposer and other named drivers Automated Business Rules Analytic Decisioning Engine Social Network Analysis SNA: Checking if new proposal (contract) would be linked Unexplained Relationships with an existing suspicious network
HOW IT WORKS Claims Address Vehicles Policy Accident Reports Insured and Driver Repair Shop Insurance Expert Agents Analitica l Models Social Network Analysis Business Rules Daily and Weekly Jobs Investigate relational links 1 2 3 SNA Claims Score Network Score
SoCIAL NETWORK ANALYSIS Screenshot 16
INSURANCE INFORMATION AND MONITORING CENTER Q&A Sigorta Bilgi ve Gözetim Merkezi