ADVANCED // MULTI DOMAIN
MODULE 07 // INSURANCE

Insurance Fraud.

Detect insurance fraud through behavioral analysis.

INSURANCE APPLICATIONS

Insurance fraud costs billions annually. ABIS adds behavioral dimension to claims analysis: how claimants interact, consistency of behavior, and patterns indicating organized fraud.

Key applications: claims behavior analysis, identity verification during enrollment, and fraud ring detection through network analysis.

Integration with Special Investigation Units (SIU): ABIS outputs prioritize investigations and provide behavioral evidence.

CLAIMS BEHAVIOR

Analyze claimant interactions during claims process: hesitation, consistency, behavioral anomalies.

CLAIMS

IDENTITY VERIFICATION

Behavioral verification during enrollment prevents synthetic identity fraud at entry point.

ENROLLMENT

RING DETECTION

Identify coordinated fraud through behavioral similarities and network patterns.

NETWORK

SIU INTEGRATION

Prioritize investigations and provide behavioral evidence for fraud cases.

OPERATIONS
KNOWLEDGE CHECK // Q07
How does behavioral analysis improve fraud ring detection?