Fraud Detect System (FDS) by DETECTsystem A/S

Autor: Detectsystem A/S

Evidence-based fraud detection in insurance: Deep inspection of documents, PDF's and images

FRAUD DETECT SYSTEM (FDS) is an evidence-based detection technology to automatically verify if a file or image is genuine or fraudulent based on scientific methodologies.

FDS can quickly verify, whether attached files to claims are genuine or fraudulent. FDS detects, if a file has been manipulated from its original source, i.e. if a geo-location, date or bearings have been changed, or a file has been tampered with by using an off the shelf editing software.

FDS can detect a multitude of files which include images, invoices, receipts, certificates, health records, employment contracts, warranties and other such documents.

The ability to deal quickly with claims is core for any insurance company, to ensure high customer satisfaction scores, while reducing claims costs by offering convenient self-service tools.

Most insurance companies would apply STP (Straight Through Processing) logic to claims falling under a certain threshold. A natural concern regarding low-cost claims would be the resulting increased possibilities of fraud below a certain value, e.g. USD 2000, where the pay-out would be less expensive, than the costs associated with manual expert forensic analysis.

Deployment of FDS is easy and agentless. FDS is installed on a dedicated Microsoft Windows Server 2012 R2 or later, either on-premise, in private cloud, or in public cloud. FDS supports VM environments and can be easily supported by MSP’s (Managed Service Providers).

For smaller and mid-sized insurance companies, the deployment is very easy and cost effective. For larger organizations, the full scalability of FDS makes it possible for it to be deployed with multiple detection engines. This enables FDS to service global or highly distributed environments which handle large volumes of files. All functionality is accessed via web-browser.

FDS makes a fingerprint (several HASH values) of all files making it possible to alert if the same file has been submitted in previous inhouse cases. By using FDS Data Point, these fingerprints can be checked in a GDPR regulated environment on a centralized database of all participating Insurance companies. Alerts are raised if the same claim, or part of it has been used before.

Detected fraud is automatically assigned to the right department. All fraudulent claims detected have evidence-based reports created for documentation in police or court cases.

FDS supports Google API, so the claim handler can easily see the policy holder’s address, the address of the reported incident, and the GPS data location of submitted images. The users can quickly compare and view on a map the distances calculated between reported location and actual location. FDS features an open RESTful WebAPI interface for easy integration with other insurance platforms and supports self-service or STP strategies.

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