Collaborative, Cross-Sector Data Sharing To Enhance Fraud Prevention Strategies

This case study demonstrates why organisations should come together and share intelligence for collective benefit to combat fraud, risk and financial crime.

A collaborative approach is vital when trying tackle potentially fraudulent activity. Fraudsters work across different sectors and so must those seeking to prevent fraud. This case study demonstrates how such a collaborative approach, across public and private sectors, to data sharing is starting to reap significant rewards.

SITUATION

Leading business insurer, QBE has been working collaboratively with Synectics Solutions for a number of years to combat fraud in the insurance sector. QBE use SIRA from Synectics Solutions – a sophisticated workflow management and data matching tool; and National SIRA – a leading database of known fraud cases, contributed to by over 130 organisations.

In recent years, the insurer has sought to increase and enhance its automated fraud detection capacity using new methods and data sources. QBE wanted to identify additional sources of intelligence to help them spot more fraud across insurance applications. The fraud team also wanted to see an uplift in the amount of fraud detected for previously investigated cases, by retrospectively matching to records, previously marked as fraud. In particular, they wanted to look at exaggerated and fabricated, third party motor and casualty claims, to see if there was any correlation between fraudulent benefit and insurance claims.

SOLUTION

The Cabinet Office is responsible for the National Fraud Initiative (NFI). The aim of the NFI is to protect public services from fraud and error, saving tax payer’s money through sophisticated data matching and analytics. The NFI has been successfully fighting fraud since 1996 and has already helped public and private sector organisations to identify £1.69 billion of fraud, overpayments and errors.

In 2017, the Cabinet Office and Synectics Solutions began a proof of concept to evaluate the potential to utilise NFI data to assist the insurance sector with detecting fraudulent claims. This was the first time that public sector data would be available to private sector organisations for fraud prevention purposes. QBE’s requirements for the integration of public sector data within their SIRA system offered the perfect opportunity to trial this new collaborative, cross-sector data sharing initiative.

RESULTS

QBE has now integrated the service into a live environment and so far the data is showing a significant positive impact. Consequently, the public sector data is now available to the insurance and finance sectors, through National SIRA, to improve fraud prevention capabilities. The NFI intelligence includes: housing benefit claim data, social housing waiting lists and more.

• 45% uplift in the identification of potential fraudulent claims for QBE, by integrating NFI data into SIRA.

• QBE has seen a significant impact on how claims would have been handled had the insurer had access to the public sector data at the time of the claim.

• In a live environment, for the first quarter, QBE set 41% of applications to fraud, suspect or under investigation.

• Demonstrates successful cross-sector collaboration.

• Enhanced investigators ability to spot a broad range of potentially fraudulent anomalies.

“We are really excited about the potential of this partnership. The Cabinet Office is committed to supporting the Government’s objective to find more fraud and the NFI product range is key to us achieving this. The NFI has already enabled participants to prevent and detect fraud in excess of £1.69 billion and we are always seeking to help target new fraud risk areas. We are delighted to now be working with Synectics and QBE to use the NFI to assist the insurance sector in its fight against fraud. The initial results are really impressive and demonstrate huge potential.”

Darren Shillington, Head of the NFI Team, Cabinet Office.

“Insurance fraud remains a major issue in our industry, but through collaboration and sharing of data, we are able to better detect and combat fraudulent claims. Working with Synectics and the Cabinet Office has already had a positive impact on our fraud identification and claims handling and we look forward to continuing to work together to fight these types of crimes.”

Jon Radford, Special Investigation Unit Claims Manager for QBE European Operations.