To support enhanced decision-making and timely interactions, insurance, banking and medical aid providers need a 360-degree view of their customer risk profile. However, the reality is that many insurance and medical aid providers rely on a variety of disparate risk processes. The widespread modernization and major regulatory changes are also forcing providers to take a long, hard look at the traditional ways of mitigating risk. Digital innovation is having a profound influence on the insurance and medical aid sector, challenging providers to evolve their risk strategies to remain competitive.
Responding to this evolution means delivering cost-effective and efficient tools, data analytics, systems and processes. It is now, more than ever, important for all insurance and medical aid providers to adapt faster than the fraudsters, by employing cutting-edge tools and making fraud prevention an integral part of every point in the transaction chain. Traditional rule-based approaches to fraud detection typically used in the insurance industries often result in many valid claims being flagged as suspicious, requiring unnecessary investigation. These false positive flags results in both unnecessary expenses being incurred, delays in paying valid claims and potential damaging relationships with clients.