A solution that automates
the detection of suspicious transactions (insurance fraud)
by systematizing the work standards and know-how of detection personnel.
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Detection of suspicious transactions using insurance fraud detection models
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Provides lifecycle management for detection scenarios
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Proven stability and completeness through deployments in public and financial institutions
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Korea’s first GS-certified scenario management solution for fraud detection
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User-friendly management environment
Product composition
AFDS
Application FDS
Early
warning
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Early warning of risk factors for claims
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Immediate payment filtering
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Provides information for deciding whether to investigate payments
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Distribution of investigation by survey level/investigator level
CFDS
Claim FDS
Investigation result decision
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Determination of investigation results using insurance fraud detection strategic models
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Analyzes and judges past data through optimized strategic models
Expert System
Expert Management System
Expert management system
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Establishment of risk factor-related data mart
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Derivation of risk factors and development of score models through statistical analysis
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Continuous addition of business rules and optimization of strategic models
AI/ML
Artificial Intelligence Machine Learning
AL/ML
application
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Comprehensive use of business rules + statistical modeling + machine learning models
Expected effects of introduction
Risk management aspect
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Preemptive response to fraud through early detection alerts
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Improves work efficiency through specific risk group analysis
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Enhances management convenience by connecting and improving the joint investigation process
Work process aspect
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Flexible and rapid response to fraud risk cases
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Improves work efficiency through exclusive analysis of specific groups
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Enhances technical support and system connectivity
IT/infrastructure aspect
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Built in an open structure to improve system connection and information sharing efficiency
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Enhances technical support convenience through the use of general-purpose technology
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Improves development/operation and maintenance efficiency by applying international standard (de Facto) visualization solutions
Organizational aspect
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Enhances work performance of reviewers/investigators by improving analysis work convenience
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Utilizes fraud prevention systems and strengthens operational capabilities through smooth collaboration between business and IT
Customer reference
