In my first post I looked at the role of analytics in policing and how analytics could and should be used to benefit modern policing. However, a key point that can be forgotten is analytics is only as good as the data it is based on. It’s vital to have
Could cheaper, entry-level smartphones offer some respite to telecommunication companies, reducing their losses due to unscrupulous customers? For the first time in seven years, Apple has been knocked off the #2 spot for worldwide smartphone sales by Chinese colossus Huawei. The Q2 2018 figures come from IDC, illustrating the high-end
What on earth am I talking about? Spotting insurance fraud, of course! An ex-colleague of mine used to aptly describe the traditional rules-based methods of spotting fraud as “if it walks like a duck and talks like a duck, it’s probably a duck.” This is, of course, true to a
The future of successful compliance will go through extremely skilled data scientists, who will become heroes in your organisation. Human instinct and analytics will help uncover financial crime together. For the last 15 years, banks and other financial institutions have been deploying AML and CFT solutions. In Europe, in line
Combating insurance fraud and anti-money laundering have always been among the key challenges of the insurance industry. Therefore, the opportunity speaks for itself: SAS has great solutions to overcome these issues, only the proper occasion to display these to the target group needed to be identified.
Government fraud defrauds the public, but how can we fight it more efficiently? Are fraud numbers too small to matter? Is there the potential of doing more using less resources? I get the impression that government agencies and organisations struggle to fight fraud, and even how to detect and recognise
The financial services industry has witnessed considerable hype around artificial intelligence (AI) in recent months. We’re all seeing a slew of articles in the media, at conference keynote presentations and think-tanks tasked with leading the revolution. AI indeed appears to be the new gold rush for large organisations and FinTech
In the medical field, an autopsy is valuable because it helps you understand the cause of death. But, what’s more valuable is identifying the leading indicators of an illness so that you can address it before the Grim Reaper comes knocking. Best in class organizations are taking a similar approach
Anyone who believes that digitization has made the issue of insurance fraud go away is unfortunately wrong. One in ten reported damages and claims are still invented or manipulated. The cost: at least €5 billion per year in Germany alone for property and casualty insurance. In other words, not even including
The most efficient organizations focus on process management. They use enterprise resource management platforms to provide functional and technical support, and organizational integration to optimize the most critical processes. Organizations can even be managed using a functional process orientation that crosses organizational silos and maintains the traceability of transactions. These
I commented before in my previous post that good fraud detection requires good data governance, which also serves many other purposes, not least to satisfy regulatory demands. But fraud is changing too: it is becoming much more the province of organized crime, and less about individuals. And fraud detection on
The fight against fraud has to be at all levels, and use all possible means available to the organization. However, it is important to distinguish between political, organizational and technical means. Persuading states to organize themselves better to facilitate exchange of information between administrations can be decisive, even with the
Today, fraud detection in the areas of financial services, citizen services and national security is becoming an increasingly relevant challenge for both private organisations and government agencies. The ubiquity of the internet, the e‑commerce boom and growing volumes of data processed in clouds necessitate the implementation of advanced IT tools.
This is the second of the seven parts of blog post series “A practical guide to tackle auto insurance fraud”. While Data Management and Data Quality are the basis for every analytical journey, and this becomes even more true for fraud detection analytics, the domain knowledge and business expertise plaid
To some people, electricity is like air: There for the taking. For others, circumventing paying a utility bill is a just cause, sticking it to “Big Energy” for their perceived transgressions against customers. In either case, not paying for energy is considered fraud and a crime. In some states, energy
Across the globe, governments are losing billions in revenues to organised VAT fraud. The most recent VAT Gap study published by the European Commission estimates that EU countries lost an estimated €168 billion in VAT revenues in 2013. That's equivalent to 15.2% of the total expected VAT revenue from the
With tax week quickly approaching, tax agencies have been issuing press releases alerting the public they’re holding tax refunds for review longer than in years past. This is a departure for tax agencies. Tax agencies have traditionally lived and died by refund cycle time. Refund cycle time, or getting refunds
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,
When it comes to fraud detection and risk mitigation, predictive modeling has earned a reputation as the “heavy hitter” in the realm of data analytics. As our celebration of International Fraud Awareness Week continues, I would challenge our readers to ask themselves this question, “Is the reliance upon predictive analytics
Another day, another scam defrauding insurers and governments. For purposes of full disclosure, the case I'm highlighting today comes from Washington's Labor and Industries (L&I), the agency where I formerly worked and headed up fraud prevention efforts, and the investigation dates back to my time there. During my time there,
Sometimes, it is good to start with a confession. I filed my taxes at the last minute. It was past time to get some money back from the IRS before they could waste $60,000 on another Star Trek spoof video. Normally I'm one of those people that files in February,
Personally, I love studies. They help put things into context, and when done well, provide an independent and hopefully unbiased view of the forces that shape our lives. They are also a great way to see government funds used in strange ways. For example, the new NIOSH (National Institute for
The first step is to answer the question of what “real-time” actually means. Depending on the program and industry speed of response, I’ve heard answers that varied from milliseconds for the biggest banks in processing credit card charges to 24 hours for some government programs. A better description of what
Fraud detection presents myriad analytical challenges: gathering sufficient known cases to make typical modeling techniques possible, gathering inputs from disparate data sources, and combining expert knowledge from investigators with findings to be gleaned from the data in an efficient way. Of course, analysts can fall into the trap of thinking
Most health care organizations either intentionally or due to some inability don’t use outside information (not just referals) in their search for fraud. There are great numbers of valid reasons for this: HIPAA, security, usable/current data sources, inflexible information systems or processes, restrictive compliance & IT departments, and the list
In the health care field, the impact of fraud, waste and abuse on payers -- whether insurance companies, government agencies or self-insured employers -- is enormous. Fraud losses weaken a payer’s financial position, with fraud loss estimates rivaling net income. Fraud losses feed the escalating care cost curve, undermining a
