Fraud Detection: Using Your Resources

Detecting auto fraud is no easy task, and one after another, people are staging accidents and benefitting from the resultant medical billing. Minimizing fraud losses can be a daunting task, but with the right strategy, your organization can nab more fraudsters than you might think.   At America’s Claims Event (ACE) this month, James Ruotolo, principal for insurance fraud at the SAS Institute, will present a hybrid approach to insurance fraud detection. Attendees at this Thursday afternoon session will learn to combine detection techniques, helping to minimize a false-positive rate while maximizing their available investigative resources.

“Individual detection methods each have value but tend to produce a high false-positive rate on their own,” Ruotolo explained. “Investigating false positives is a waste of limited SIU capacity.”

Ruotolo says that the biggest challenge today for special investigation units (SIUs) is the need for a shift in thinking and methodology to address organized fraud exposure. In this interactive session, Ruotolo will discuss the pros and cons of various detection methods, how a hybrid approach can combine the best features of each detection method, and how to overcome the hurdles to implementing a fraud detection technology program.