Tag Archives: Insurance

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

Cybersecurity risk score scale
Jun262017

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_insurance_Strategy-Director-featured-image
Oct112016

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

Sep012016

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
Jul282016

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
Jan062016

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
Sep172014

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

Sep212012

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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