Hill Dickinson Fraud Unit [HDFU] has analysed ten years of historic claims data to develop a sophisticated fraud risk profiling model which risk assesses and scores individual motor claims and the claimants within them. The resulting output allows clients to align their counter fraud responses towards a level of risk they deem acceptable.
The model forms the basis of new rules built to interrogate new claims data through HDFU’s Netfoil Mass Data Analysis [MDA] service. The fraud risk profiling model allocates points to multiple risk factors. The resulting risk score for each claim and claimant washed through the database is returned in an intuitive format and spreadsheet. HDFU advises on those claims considered highly suspect and warranting further investigation. Insurer clients can adapt their own benchmark up or down to meet their own risk parameters.
Typically, counter fraud databases offering a fraud screening solution base their results on simplistic rule breaches, with outputs delivered in the industry’s traditional Red Amber Green [RAG] status format. This approach, whilst historically successful in identifying potentially fraudulent claims, delivers a high false positive ratio, demanding significant human intervention and associated cost. The new sophisticated fraud risk scoring matrix from HDFU delivers a ground breaking false positive ratio of less than 3%. In addition, the elemental approach to scoring delivers the ability to identify single high risk persons within an incident. This enables HDFU to focus any resulting investigation, leading to reduced claims life cycle and increased return on investment for clients.
Peter Oakes, Head of Fraud, Hill Dickinson says: “Fraud risk profiling and the new MDA process is part of an ongoing Netfoil development programme. HDFU is uniquely placed to be able to raise the bar on fraud screening in this way, due to our continued investment in our analytical expertise and our Netfoil database with its rich mix of defendant and claimant data sources.”
