International insurance fraud detection

Achmea, KBC, AXA

Customers

Achmea, KBC and AXA

SOLUTION

Custom made solution based on knowledge analyses, knowledge representation, knowledge management, IFTTT viewers, AI API

Commissioned by Achmea, KBC and AXA, Bolesian developed an international fraud detection network. In the case of international car accidents, about 7% to 10% of the reports present a form of fraud. The problem is that each country handles car insurance differently and that the software systems inherently function differently. Many claims are handled automatically and international claims handlers still communicate a lot by email or phone. They are unable to detect so-called chain fraud. In chain fraud, criminals travel from country to country to have the same damage cashed in every time. A well-known trick is the ‘Berliner model’. Hereby an expensive car that already has damage is purchased. The car is transported to a location and an accident with the expensive car is staged.

The system we developed monitors all international digital traffic between insurance companies. When cases – such as the Berliner trick – are recognized by the system, a signal is sent to the insurer who can conduct additional investigations into the suspicious report.