Fraud Detection of Travel and Personal Accident Insurance Claims

Implementation Time:
9 months
Solution Provider: AI Singapore

Based in Singapore, SOMPO Asia is the regional HQ for its Asia Pacific entities, including Sompo Insurance Singapore. The SOMPO Asia entities exclude Japan and is part of Sompo Holdings headquartered in Tokyo, Japan. With more than 70 years of trusted presence in Asia, their business spreads across 14 markets with over 4,000 employees in the region. They are now the Top 10 Largest Non-Life Insurance Companies in Indonesia and Malaysia.

  • Currently, claim handlers review new daily claims manually, which is time and labour consuming.
  • Simple claim requests cannot be processed promptly in this manual workflow.

How can Sompo develop a fraud detection application to automatically flag out potential suspicious cases for future investigation, and identify valid claims as candidate for straight-through claim payment?

A machine learning solution was developed to process, identify and rank suspicious travel and personal accident claims by giving each claim a fraud score – done daily; results were then submitted for processing by human specialists

Models are trained on a smaller, manual labelled data set that is complemented by other data sources e.g. data from internal Sompo claims systems

A pipeline was also implemented to allow retraining and updating of models when more data is available

Outcome

  • 100% fraud detection coverage thus reduces potential leakage
  • Special Investigation Unit that can prioritize and focus on high probability cases
  • Reduce claim handling time for low probability claims
  • By identifying safe-to-pay cases, Sompo aims to enable 10-20%* of their customers receive their claim payments within minutes
  • Production deployment in Sompo Insurance Singapore is underway

PDF Document

This is the last content of this tab. If you do not see any resources above, it means the solution provider have not provided any resources. Feel free to contact Solution Provider for more information.

Contact Us
The enquirer name
Company Name

Implementation Time

9 months

Use Case Brochure