Tag Archives: Insurance

Fraud & Security Cybersecurity Insurance – 3 Reasons Businesses Aren’t Buying

Cybersecurity risk score scale

We recently commissioned a study from independent research company Ovum on how organizations are tackling cybersecurity and what they plan to do next. Losses because of a data breach or other cyberattack can be severe, particularly when factors such as customer and shareholder confidence are taken into account. We therefore expected that cyber risk insurance would be an increasingly important way in which organizations are mitigating their risk. The results were far from uniform: The UK was the most insured country we surveyed, with 69% of respondents holding some kind of insurance, and the USA was the least insured – only 51% of US respondents had any kind of cyber risk insurance. Across the industries surveyed, financial services firms were the most likely to be insured (71%), and healthcare the least likely (26 percent). Even when businesses have invested in cyber risk insurance, it’s unlikely to cover them for all... [Read More]

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Analytics & Optimization Fast, Personalized Insurance Decisioning: Q&A with Infosistema


Infosistema, a business and technology consultancy, wanted to build a solution that would help its insurance company clients create a personalized experience for each prospect and customer. Working with FICO, the company now can build flexible and customizable auto insurance pricing and life insurance underwriting decision-making solutions, with advanced simulation capabilities, in eight weeks. I recently had the chance to speak about this with Alexandre Lee, Partner and Board Member at Infosistema. Q: Can you please tell me a bit more about Infosistema? Alexandre: Infosistema is a consultancy focused on insurance and banking. We offer web portals, mobile applications, business process management solutions and service-oriented analytics to help insurance and banking institutions all over the world. Our focus is on staying innovative by investing a lot in research and development for our products. Q: What business challenges were you looking to solve when you teamed up with FICO? Alexandre: As... [Read More]

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Fraud & Security Video: How SulAmérica Uses Analytics to Stay Ahead of the Game in Insurance


Ever wonder how SulAmérica combats fraud, waste and abuse? In the video below, Umberto Reis, IT Senior Manager at SulAmérica, notes that of the multi-billion dollar Brazilian health insurance market, roughly 20% may be waste and abuse. Needless to say, it’s a challenging market in which to be profitable. To tackle this complex problem, the insurer uses a combination of FICO analytics and decision management solutions, including FICO® Blaze Advisor® Decision Rules Management System and FICO® Insurance Fraud Manager. This has allowed SulAmérica, the largest independent insurance group in Brazil, to become much more agile and drive continuous improvement. For more information on this success story with SulAmérica, read our blog post: How SulAmerica Fights Insurance Fraud, Waste and Abuse.

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Risk & Compliance Using Analytics to Attack Opioid Abuse

Analytics + Opioid Abuse Blog

Recently, congressional staff requested a briefing from FICO on how our analytics are tackling the opioid epidemic – an issue that, despite pervasive gridlock in Congress, has become a priority for both Democrats and Republicans. Our experts welcomed the opportunity to share their experiences. We believe that the increased use of analytics can play a pivotal role in confronting this challenge. Opioids are a class of drugs that include heroin as well as pain medications such as codeine, oxycodone and morphine. In 2014, according to the Centers for Disease Control, more than 28,000 people died from opioids – a number greater than the deaths from traffic accidents that same year. And the opioid problem is getting worse, with increasingly more deaths involving fentanyl and other synthetic opioids. The House and Senate recently approved a bill addressing the opioid crisis by nearly unanimous votes. Though both parties wanted additional provisions, the... [Read More]

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Fraud & Security How SulAmerica Fights Insurance Fraud, Waste and Abuse

SulAmerica logo

One of the biggest challenges in fraud detection today involves not credit but insurance claims. That’s one reason to celebrate this year’s winner of the 2015 FICO Decision Management Award for Fraud Control, SulAmerica. SulAmerica, the largest independent insurance group in Brazil, where fraud, waste and abuse can occur in nearly 20 percent of insurance claims. After only a year in deployment, SulAmerica is realizing R$1.2 million per month in savings. SulAmerica uses FICO® Insurance Fraud Manager, a solution that verifies that payments and claims are accurate, valid, and compliant with provider agreements. Insurance Fraud Manager is used within SulAmerica’s claim process to identify fraudulent claims, as well as waste through clerical or systemic error. “The month-to-month improvement in savings through denied claims has been outstanding,” said Fabiano Carraro, Intelligence Health Claim Superintendent at SulAmerica. “This solution is a fantastic example of the longstanding partnership between FICO and SulAmerica. FICO... [Read More]

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Fraud & Security More Than Losses – Fraud Is a Brand Issue

Fraud locks

I recently joined FICO as the General Manager for Global Fraud and Security Solutions, based in New York. I am joining FICO after almost 20 years in the payment card industry, and thought I knew what fraud was – namely unauthorized or fraudulent credit card transactions. In my brief time here, through very productive conversations with our clients in the financial industry and outside, I am realizing that I had significantly underestimated the breadth and challenges of what is fraud today. Not only are financial institutions challenged by traditional payment card fraud, there is growing pressures from retail banking fraud, e-banking, first-party fraud including fraudulent applications for new accounts such as mortgages, employee fraud, and of course the emergence of digital and mobile transactions which are still being defined. In addition, fraud in healthcare insurance and property & casualty (P&C) insurance continues to grow. These fraud challenges are global in... [Read More]

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Analytics & Optimization Decisions in the Cloud


Many companies are thinking about ways to take advantage of cloud computing.  SulAmérica is turning those thoughts into action. As Brazil’s biggest independent insurance company, they needed a better way to connect with their 30,000 brokers throughout the continent in order to make more consistent, flexible underwriting decisions. SulAmérica will use FICO® Blaze Advisor® , hosted on Google’s cloud, to easily manage and change business rules while keeping hardware costs low. This is a great example of the benefit of putting decision services in the cloud. The high volume transactions associated with decision services make the cloud ideal for keeping IT costs down while providing flexibility and capacity to handle spikes in volume. And in a world where companies can no longer wait months to deploy changes to their decision services, the cloud is a way to circumvent the IT backlog and get to market faster. So what does it take to put decisions in the cloud? Cloud Flexibility – every cloud vendor has a different set of capabilities...

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Analytics & Optimization Decision Management for Insurance Underwriting


We recently posted a press release describing how Lion of Africa is using FICO Blaze Advisor for their underwriting needs. Lion of Africa is one of the leading insurance companies in South Africa and is working to empower and transform South Africa’s financial services sector. This is a great example of how we’re seeing more of our customers use rules and analytics together. Here are some key take-aways from this interesting use case: Industry: Insurance (commercial and personal lines segments) Company: Lion of Africa Business Challenge: Reduce costs and put more competitive offers into the market faster using a single rating engine. How Blaze Advisor Helped: Business User Control: Blaze Advisor provides the ability to create, modify, test and monitor underwriting decisions across Lion of Africa’s business, eliminating the cost and effort of supporting several different rating engines. This gives the entire underwriting team the flexibility and control to meet each customer’s needs swiftly. Regulatory Transparency: Blaze Advisor...

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Analytics & Optimization Live from InterAct – preshow tutorials


-- Posted by Carole-Ann We flew into NY on Monday.  After what seemed a long day of internal meetings and presentation rehearsals, we started the show in the afternoon with our tutorial.  I was part of the "Operationalizing Analytics" track. Scott Horwitz talked about the how Insurance companies can benefit from Business Rules, Decision Simulation, Predictive Analytics and Decision Optimization.  If you have been reading this blog, these should not be new concepts to say the least.  It was good though to engage the crowd on their current practices. I was responsible for the Decision Simulator part and demo.  It was refreshing to see heads nodding when I talked about existing customers' experiences. Horia finally showed a demo on Decision Optimization.  Customers had lots of questions on regulatory compliance.  I anticipate that we will get more and more compliance questions over time, especially as the Obama Administration defines new rules for the Insurance business. Before the Welcome reception,...

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Analytics & Optimization BEA on Event Driven Architecture Sounds a lot like EDM


(Posted by guest Blogger, Gib Bassett) Yesterday BEA Systems released a white paper summarizing their findings of a customer study regarding Business Process Management (BPM).  The paper is titled “The State of the BPM Market – Business and IT: Solving Process Problems Together.”  BEA also culled through numerous analyst and other industry expert insights to narrow in on the key trends driving adoption of BPM related technologies.  There were two especially notable items in the report that show an Enterprise Decision Management (EDM) approach to operational decision automation, connection and improvement is becoming an increasingly mainstream concept – even if the term EDM isn’t the label. First, the report connects BPM to the growing trend toward Event Driven Architecture (EDA), a term applied by IDC in 2007 to describe an IT infrastructure blending: “Event Middleware and Complex Event Processing,” “Event-Enabled BPM Suite,” “Event-Enabled Process Modeling,” and “Business Analyst Skill Set.”  The business driver for...

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