Insurance Fraud Detection Improved by 50%

Client Overview

A leading multinational insurance and reinsurance provider faced mounting challenges in financial fraud detection across a portfolio of 120 high-value accounts. With growing data complexity and regulatory scrutiny, the client required a scalable fraud detection solution that delivered speed, accuracy, and compliance.

Problem Statement

Despite existing controls, the client’s fraud monitoring faced key roadblocks:

• Limited fraud signal identification within large and diverse financial datasets
• Unstructured data formats, such as non-machine-readable PDFs, leading to data loss
• Manual workflows that delayed fraud case resolution and led to oversights
• High investigation costs and elongated turnaround times

Solution Provided

Decimal Point Analytics deployed Fidelity Pulse, its proprietary AI-powered fraud detection platform, as part of its Risk & Compliance Services suite. Key solution components included:

• Automated anomaly detection using AI models to flag suspicious activity in real time
• Data standardization pipelines that converted unstructured PDFs into structured, machine-readable formats
• Advanced fraud analytics and financial modeling to detect risk patterns and prioritize suspicious accounts by severity
• Detailed fraud intelligence reports to support decision-making and audit trails

Outcome

The engagement delivered quantifiable impact:

• Identified 14 suspicious accounts out of 120 reviewed
• Improved fraud detection speed and accuracy, cutting down on false positives
• Strengthened customer compliance documentation and overall data quality
• Achieved 50% increase in fraud detection efficiency through intelligent automation

Key Takeaway

Combining fraud detection software, AI models, and domain knowledge allows insurers to reduce fraud exposure, cut costs, and accelerate decision-making. Automation brings scalability without increasing overhead.

Explore how our AI-Powered Fraud Detection Services can safeguard your operations.
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