In Part 1 of this blog series, I touched on the problems created by the underground economy, and framed the size and scope. But important questions remain about the types of businesses that are part of the underground economy, how they do it, and what the driving forces behind this
Historically healthcare has been most ‘self’ motivated to improve its ‘cost containment’ processes and methods. This is evident from the significant gap that exists between the technology and process in finance versus healthcare. Many healthcare organizations (either government or commercial) are not ‘profit’ oriented – take the Blues for example,
When we talk about digital customer services, it’s all about creating online self-service capabilities for our customers. This is great for everyone! We’ve made it easy for the customer to get what they need; it’s cheaper and faster for organizations to deliver the service to the customer. Need a copy
The underground economy is driving a hole in the collection of income taxes, social security, unemployment and Medicare to the tune of hundreds of billions of dollars annually within the United States. Yet significant questions remain about how big the problem is, as well as what should be done about it.
We've explored data provenance and the importance of data lineage before on the Data Roundtable (see here). If you are working in a regulated sector such as banking, insurance or healthcare, it is especially important right now and one of the essential elements of data quality that they look for
It is clear from many of the comments arising from this year’s Insurance Times Broker Service Survey that brokers value underwriters who are open-minded and willing to adapt wordings and terms where possible to accommodate clients’ individual needs. They also value a close dialogue and partnership with underwriters who are
According to broker’s “best” and “worst” verbatim responses in this year’s Insurance Times Broker Service Survey, insurers who act quickly to verify and settle claims are their preferred partners. This year’s importance scores reveals brokers are placing a stronger emphasis on claims in comparison to previous surveys. Those instances where
So much for a single version of the truth.
Earlier this year, I was speaking with an insurance executive and he said something that turned out to be my favorite quote of 2014: “Premium revenue is like heroin.” While this seems like an unlikely analogy or simile?. The point this executive was trying to make an interesting argument. Insurance
Every day there are news stories of fraud perpetrated against federal government programs. Topping the list are Medicaid and Medicare schemes which costs taxpayers an estimated $100 billion a year. Fraud also is rampant in other important federal programs, including unemployment and disability benefits, health care, food stamps, tax collection,
All of us are familiar with common fraud types. Insurance fraud, credit card fraud, identity theft, and tax evasion are among the most recognized areas. But, there are many other fraud types that have a big impact on our daily lives, yet receive little attention in the media and among
Is fraud like a snowflake, and every one is unique? Not really. There is, however, an increasing number of methods and schemes that show up and expand the range of issues we need to look for every day. To celebrate International Fraud Awareness Week this year, I'm going to spend
Big data is already dead!!! Long live big analytics! In good writing, apparently, someone needs to die in the first line and big data is a sensational, front-page victim. Some trends indicate that the “big data hype” has already peaked. Regardless of whether this is true and a post-hype hangover
For most people, this time of year means celebrating cherished, personal traditions… helping those less fortunate…flocking to stores in droves…the company holiday party… For the SAS Security Intelligence team, it means identity theft…benefits fraud…unemployment insurance fraud...insider threats. Why? Because next week is International Fraud Awareness Week! And we’re celebrating by
Earlier this week I managed to catch up briefly with Christoph Sporleder, Vice President Centers of Excellence for EMEA & Asia Pacific, to talk Hadoop, big data and get some of his views on where we might be headed with big data. Mark Torr: Is big data just a buzz
It's time for a fall fraud roundup. Bad deeds swirl around like so many dry leaves, and I'd like to highlight a few of them this week. It can happen anywhere, even in sports, and no, I'm not picking on those shoplifting Dallas Cowboys here. An MLS referee was suspended for workers' compensation
This post will violate the “what happens in Vegas stays in Vegas” rule, because last week I had the pleasure of attending and participating in the Analytics 2014 event there and want to share some of what I heard for those who couldn’t attend. I was joined by over 1,000
Last week, I was fortunate enough to attend the Insurance Networking News Analytics Symposium. This great event had several engaging speakers. As analytics becomes more prevalent within insurance, it was refreshing to see that many organizations discuss their successes and share best practices in this essential aspect of the business.
The tail of a probability distribution is an important notion in probability and statistics, but did you know that there is not a rigorous definition for the "tail"? The term is primarily used intuitively to mean the part of a distribution that is far from the distribution's peak or center.
Is the type of car you drive more likely, or less likely, to get a speeding ticket? Let's analyze some data to find out! Do red cars attract more attention from the police, and get more tickets? How about cars with a 'racing stripe'? Or cars with a big chromed motor,
People often talk about the customer experience and the engagement model. This is an easier task when a business has regular interactions with its customers like banks and retailers. However, for insurers, this is a challenge. First of all, insurers have infrequent interactions with their customers. When there is interaction,
The first time I used the Internet it blew my mind. As a diplomat brat, at any point in time everyone I knew was everywhere but where I was. Thanks the miracles of Gopher, Veronica, IRC and email, the tyranny of distance didn’t seem so oppressive any more. When I
Stress testing is not new to the risk world but has been a major focus since the GFC (Global Financial Crisis). For a number of years now, stress testing has helped analytical specialists quantify various aspects of potential loss. What is new is the introduction of regulatory stress tests which
In the morning at 6am my iPhone buzzes. But it is not the alarm clock, rather it's important information from an app. What is this, I think to myself and look sleepily at the screen: "Danger of black ice! Already 15 km traffic jam on the A3 towards Cologne!
Let’s go back in time to the summer of 2007. The original iPhone had just been launched. Miley Cyrus was Hannah Montana. The San Antonio Spurs were NBA Champions, and LeBron James was the savior of Cleveland Cavaliers. Insurance Executives were only concerned about legacy replacement systems. On the surface,
In my last three posts on data ethics, I explored a few of the ethical dilemmas in our data-driven world. From examining the ethical practices of free internet service providers to the problem of high-frequency trading, I’ve come to realize the depth and complexity of these issues. Anyone who's aware of these
The US health care industry is always getting a bad rap. It takes heat for being too expensive or not efficient enough or just too complicated. We know we need it, and that living long and healthy lives requires it. But we also know we love to complain about it
Jill Dyché, internationally recognized speaker, author and business consultant, spends her days talking to businesses about big data – how they’re using it, challenges, successes, strategies, plans and more. What she’s hearing again and again from IT leaders is that they have to innovate with big data, move quickly and
With all the changes the Affordable Care Act brings, including new care and payment models, there is an increase in provider’s need for data. While some large health systems are able to learn much about a patient’s full course of treatment by integrating their systems, the majority of health care
While at SAS Global Forum 2014 I attended a talk by Jorge G. Morel on the analysis of data with overdispersion. (His slides are available, along with a video of his presentation.) The Wikipedia defines overdispersion as "greater variability than expected from a simple model." For count data, the "simple
