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16. Dezember 2015

SulAmerica Wins 2015 FICO Decision Management Award for Fraud Control

16. Dezember 2015

SAN JOSE, Calif. — December 16, 2015

  • Panel of independent experts recognizes Brazilian insurer SulAmerica for outstanding results in detecting fraud and reducing fraud losses and costs.
  • SulAmerica is saving R$1,2 million per month detecting fraud, waste and abuse in medical claims with FICO® Insurance Fraud Manager.

Analytics software firm FICO (NYSE:FICO) today announced that the winner of the 2015 FICO Decision Management Award for Fraud Control is SulAmerica, the largest independent insurance group in Brazil. SulAmerica was recognized for the outstanding results that it achieved in detecting fraud and reducing fraud losses and costs. 

SulAmerica implemented 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. In Brasilien tritt bei nahezu 20 Prozent der Versicherungsforderungen Betrug, Verschwendung und Missbrauch auf. After only a year in deployment, SulAmerica is realizing R$1,2 million per month in savings.

"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 provides the core analytic expertise, while the SulAmerica team provides the domain knowledge and rule development."

"Fraud, waste and abuse in insurance is a huge problem," said Michael Wu, chief scientist at Lithium Technologies and one of the 2015 Decision Management Award judges. "SulAmerica is breaking away from the whole 'pay and chase' scenario and using analytics to detect potential fraud prior to payment. The judges were impressed with its data-driven approach and the benefits it has achieved."

"It's interesting that this year's winner in the Fraud Control category is an insurer," said Bob Shiflet, managing director for fraud solutions at FICO. "As insurers tighten the net on fraud, waste and abuse, they are seeing dramatic gains."

About the Decision Management Awards
The 2015 Decision Management Awards are presented in six categories, reflecting the breadth of ways that businesses deploy decision management solutions: Analytic Excellence, Customer Onboarding and Management, Debt Management, Decision Management Innovation, Fraud Control and Regulatory Compliance.

A panel of independent judges evaluated nominations based upon measurable improvement in key metrics; demonstrated use of best practices; project scale, depth and breadth; and innovative uses of technology. This year's judges included:

  • Philip Alexander, Editor, Global Risk Regulator Magazine
  • Michael Versace, Global Research Director, IDC
  • Joel Wells, Director Application Development, Discover Financial Services
  • Michael Wu, Chief Scientist, Lithium Technologies

Winners will also receive recognition at FICO® World, which will be held in Washington, D.C., from April 26-29, 2016.

Über FICO
FICO (NYSE: FICO) ist ein führender Anbieter von Predictive Analytics und Softwarelösungen für Entscheidungsmanagement, das Unternehmen in über 90 Ländern dabei unterstützt, bessere Entscheidungen zu treffen, um Wachstum, Profitabilität und Kundenzufriedenheit zu steigern. Der zukunftsweisende Einsatz von Big Data und mathematischen Algorithmen zur Erstellung von Prognosen zum Kundenverhalten hat ganze Branchen grundlegend gewandelt. Die Analytics-Softwarelösungen und -Tools von FICO werden in den verschiedensten Branchen verwendet, um Risiken und Betrugsfälle zu verringern, profitablere Kundenbeziehungen aufzubauen, Abläufe zu optimieren und strenge regulatorische Vorgaben zu erfüllen. Many of our products reach industry-wide adoption. These include the FICO® Score, the standard measure of consumer credit risk in the United States. FICO-Lösungen integrieren Open-Source-Standards und Cloud Computing, um so maximale Flexibilität und schnelle Bereitstellung zu ermöglichen und Kosten zu reduzieren. Das Unternehmen hilft Millionen von Menschen dabei, ihren persönlichen Kreditstatus zu verwalten. FICO: Make every decision count™. Learn more at www.fico.com.

For FICO news and media resources, visit www.fico.com/news.

FICO and “Make every decision count” are trademarks or registered trademarks of Fair Isaac Corporation in the United States and in other countries.

Newsroom-Kontakte

Greg Jawski
Amerika

greg.jawski@porternovelli.com
+1 212-601-8248

Darcy Sullivan
Europa, Naher Osten und Afrika

dsullivan@fico.com
+44 (0) 209-940-8719

Saxon Shirley
Asien-Pazifik

saxonshirley@fico.com
+65 6422-7795

Marisa Arribas
Lateinamerika

marisaarribas@fico.com
+1 786 482 7231

Camila Placa
Brasilien

camilaplaca@fico.com
+55 11 5189-8258