Admiral: for discovering insurance fraud
The family of computer products Admiral enables its users to discover and efficiently manage complex insurance fraud.
About the new product
Admiral is a computer product (a family of products) that enables its users to discover complex insurance fraud and efficiently manage them. The fraud management process covers all activities, from detected fraud to saved money. Because fraudsters adapt their tactics all the time, the process itself needs to be inherently set for constant improvement. The product can establish a learning process and adapt to changing tactics of fraudsters. After detecting a fraud, Admiral ensures that the company chooses the appropriate legal and court procedures. It also efficiently guides them through complicated procedures that lead to compensation.
The product Admiral Collaboration
detects even the most complex cases of organised computer frauds in motor insurance. The user connects
with insurance companies from different countries and inquires
potentially interesting information. Users can put together a joint investigation team
with investigators from other countries, connect information and obtain missing data. Connectivity is the only reliable way of detecting organised fraud beyond an individual country’s borders.
The product Admiral Detection
is used for introducing proactive fraud detection that helps the user increase the efficiency of the investigation process. It connects insurance associations of different countries. The information exchange between insurance companies and insurance associations is safe and legally compliant. The programme prioritizes the cases that are potentially fraudulent. It then provides explanations, reports, documentation and advanced visualisation, which help the investigators thoroughly review the case and understand what makes it suspicious.
The product Admiral Enterprise
explains exactly which circumstances make the case suspicious. It helps examine different interpretations of an event and gives useful tips that help determine what had really happened. It helps manage the entire investigation process, from fraud detection to saved money. The programme helps manage investigated cases and documents throughout the entire process. The entire process is recorded, which enables users to monitor and optimise it according to new findings.
enables enrichment of data from public (structured, semi-structured and unstructured) and private data sources. It provides more and better information to the users, which can be crucial for solving individual cases. Admiral Index can be used as an upgrade to Admiral Detection and Admiral Enterprise, and so transfers the information of publically available sources such as internet and social networks. Social networks (Facebook, Twitter, LinkedIn and others) can reveal connections between people who know each other, but shouldn’t.
By using social networks, Admiral Index gives more data about all people connected to the case. With help of sources that have information about the weather and location, Admiral Index can provide more data about the investigated event, as well as offer appropriate data (e.g. location of people, vehicle history, company information) from other publically available (free of charge and payable) databases and registers. The data that Admiral Index gains from private sources are connected to law practices, mechanical workshops, medical examiners, etc. and can provide answers to several relevant questions, such as: who published the medical certificates? Did two people, who supposedly don’t know each other, both visit the same small mechanical workshop? Which agent sold the insurance? Were the damage claims prepared by the same lawyer?
The problem, use value and competitive advantage
Insurance companies usually can’t discover the most complex insurance frauds. Consequently they spend a lot of time investigating low-value claims instead of focusing on more expensive ones, which would bring the biggest return on investment.
Insurance companies can detect frauds in two ways: manually, by carefully checking a certain number of randomly chosen claims, or by using software solutions, which are much more successful. The computer system automatically checks all claims and detects the possibly fraudulent ones. The system leads the investigator, which simplifies the work process that becomes much more efficient. By using the programme, insurance companies successfully follow the goal of reducing losses occurring due to insurance fraud. With products Admiral, it’s possible to lower the amount of fraudulent claims for up to 40%.
Main customers of the company Optilab are insurance companies whom they help fight against frauds and anomalies, and thus significantly improve their business results and competitiveness.