IBM Counter Fraud Management accelerator for Insurance

Analytics services
Datasheet
IBM Analytics
IBM Counter Fraud
Management accelerator
for Insurance
Rapid implementation of insurance
industry content
IBM Counter Fraud Management (CFM) provides capabilities across
Highlights:
• Reduce the time to value for
insurance customers
• Improve intelligence and investigation
capability faster
• Minimize the demonstrable time-to-value for
detection and prevention for fraud and
financial crime
• De-risk and optimize the
implementation process
the lifecycle of fraud and financial crime from detection and response to
investigation and discovery.
CFM accelerator for Insurance provides rapid delivery of out-of-thebox capabilities targeting core insurance operational problems and
demonstrates fast return on investment.
Many organizations have made significant investments in discrete
solutions that address parts of the problem and the flexible deployment
patterns of IBM CFM will complement any existing performant
solution to close areas of weakness and vulnerability.
Overview
Delivering a successful solution requires an understanding of the
targeted uses cases and requirements on top of the usual process and
rigor of IT projects. The Safer Planet services team has over 20 years’
experience delivering solutions using industry and investigation specific
content across a wide range of public and private sector projects. This
understanding and experience will reduce the implementation time and
overall costs; deliver a more performant initial design; and educate your
team through mentoring and knowledge transfer to maximize the
productivity gains. While self-sufficiency is always a project objective,
further support can of course be provided throughout the ownership
lifecycle to ensure your intelligence approach is optimal.
The Safer Planet team will work with your business owners and subject
matter experts to deliver core capabilities to support compliance and
fraud use cases including:
Analytics services
Datasheet
IBM Analytics
Use cases
• Resolving customer identity
The Safer Planet team will work with your business owners
• Screening against Watch lists (OFAC, FinCEN, Dow Jones,
in-house Watchlist)
and subject matter experts to deliver core capabilities to
• Screening against own “Good Guy” list
support compliance and fraud use cases including:
• Screening of new and existing customers, transaction
Auto claims fraud
initiators, beneficiaries and intermediaries
The primary focus of the Auto Claims use case is a set of rules
• Generating and prioritizing alerts for transaction fraud
for scoring and assessment and includes:
based on this list analysis
• Customer identification (entity resolution, list screening)
•Scoring
Spatial-Temporal Analysis
• Generating and prioritizing alerts
Spatial information for an event, party, or physical object can
• Investigating and escalating alerts, enhanced due diligence,
provide valuable insight for the detection and investigation
relationship analysis
process. The first application of spatial information provides a
• Quality review of cases
mean to evaluate the risk associated with a particular object or
event based on the geographical information. The second
Know Your Customer (KYC)
application is to integrate with the temporal in-formation of
KYC verifies the identity of clients through such activities as
the event to generate alerts for suspicious activities. There are
the collection and analysis of basic identity information and
four main components in the Spatial-Temporal content in IBM
monitoring of a customer’s transactions against their expected
Counter Fraud Management:
behavior and recorded profile. It includes:
• Spatial sample data ingestion
• Customer identification (entity resolution, list screening)
• Spatial risk determination
• Customer due diligence
• Spatial risk assignment
• Scoring (customer on-boarding and life cycle score)
• Spatial event statistical profiling
• Generating and prioritizing alerts
Executive Dashboards
• Investigating and escalating alerts, enhanced due diligence,
Preconfigured reports that comprise an Executive Dashboard
relationship analysis
for tracking the following information from CFM:
• Quality review of cases
• Program effectiveness
• Dashboarding and reporting
• Process efficiency
List Screening
• Customer risk
Screening of customer files, new customer records, changes to
• Threat level
customer records, verification against lists, customer file and
CFM accelerator for Insurance also includes industry content
wire transactions against external and internal watch lists. The
to support role, case and investigation management. De-tailed
choice of lists and frequency of matching and other matching
content is constantly being enhanced and is available on
requirements are configurable for each list. The screening is
request but briefly includes:
done on the basis of the matching algorithm specified by each
insurer and involves matching specified key data criteria in the
Role management: A variety of supervisory, administrative,
customer’s record with data elements available in each list; for
analytical and investigative roles are included as standard.
example, name, date of birth, social security number etc
and includes:
2
Triage and assignment: Supervisory routing of cases with manual
• Reducing total cost of ownership
and automated case assignment
• Information sharing through our mentoring approach
Case Work: Content and context to support the roles outlined above
Case Workflow: Workflow to underpin the process from triage to
Available for any delivery approach, the IBM
investigation and quality control
Safer Planet Services team will produce results quickly, and
Dashboards and reports
will help put your project on the road to success.
The Safer Planet approach is to work with your team and provide
For more information
knowledge transfer during the deployment process backed by
• Visit the Safer Planet Services Website:
classroom training where required. Our objective is to
ibm.com/developerworks/saferplanet
enable self-sufficiency.
The flexible, open-box design of IBM CFM supports any fraud and
financial crime requirement – please contact Safer Planet Lab Services
to find out more.
Deliverables
This offering includes the following project stages and key
deliverables:
• Project plan
• Architecture design
• Functional specification
• Installation of software
• Integration with existing data sources
• Installation report
• Mentoring, knowledge transfer and QA
Your independence is our greatest success
Nothing is more important than transferring IBM expert knowledge
to your organization. This provides long-term self-sufficiency through
a mentored approach.
Engage today
With a world-wide team of highly trained professionals, the IBM
Safer Planet Services team can help build your solution with
confidence while assuring that the business needs and expectations of
your organization are met.
Our experts are ready to assist your organization with:
• Establishing project goals and expectations
• Maximizing the return on your investment
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