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Case Studies

Investigation of insurance fraud

BAE Systems Detica. part of the defence and security firm BAE, has closed a strategic deal with Canadian National Insurance Crime Services (CANATICS). It’s to detect suspicious auto insurance claims in Canada.The service, commissioned for a five-year period, will initially focus on Ontario, with a view to expanding across Canada.

CANATICS is a not-for-profit body focused on using analytical tools to identify potentially suspicious claims in insurance industry pooled data to aid further investigation by insurers.

The deal represents an expansion of BAE Systems Detica’s Canadian business, which operates out of Toronto, and in particular the growth of Detica’s global insurance fraud prevention offering. Detica’s NetReveal anti-financial crime solutions are currently being used by over 130 clients, spanning four continents, including six of the top 10 financial banking and insurance institutions in the world.

Automobile insurance fraud is a cost to consumers across Canada, and particularly in Ontario. A recent report, prepared for the Ontario Auto Insurance Anti-Fraud Task Force, estimated that as much as $1.6 billion a year is paid by insurance companies in response to fraudulent or inflated claims. The Task Force recommended that insurers move aggressively to establish an organisation that would pool and analyse claims data in order to identify potential cases of organised or premeditated fraud. CANATICS has been set up.

According to Detica its NetReveal product provides automated risk scoring and prioritisation of suspicious claims as well as exposing hidden patterns of fraudulent behaviour.

About NetReveal

The software integrates data from multiple systems and insurers to create a single view for fraud detection and investigation with data integration and hosting. NetReveal combines predictive analytics with social network analysis to identify suspicious behaviours and detect fraud. According to Detica it can also reduce exposure to organised and opportunistic fraud and improve customer service across an insurance business.

Chris Green, Managing Director, Financial Crime, BAE Systems Detica, said: “We are truly committed to helping the Canadian insurance industry combat fraud for the benefit of Canadians. Our experience with other national insurance bodies, such as the Insurance Fraud Bureau in the UK, shows that the best way to combat insurance fraud is for a wide range of insurers to pool and analyze their data centrally. As a consequence, fraudsters can less easily escape detection.”

And Ben Kosic, CEO, Canadian National Insurance Crime Services, added: “We have chosen BAE Systems Detica to work with us on this important project as we need a partner who will provide the critical knowledge, skills and services that will enable CANATICS to provide the insurance industry with superior intelligence derived from analytics on industry-pooled data. By working with Detica, we can help ensure that investigators, at our insurance members, focus their investigations on the right claims with the ultimate goal of reducing organized and premeditated fraud in Canada.”


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