Key Highlights
- OptiSol partnered with a leading insurance provider to automate fraud detection and improve claims processing efficiency by addressing manual review processes.
- We implemented AI and machine learning models, including Isolation Forest and Support Vector Machines, to identify anomalous claims by analyzing key variables like claim timing and driver-related factors.
- The solution streamlined the claims process by reducing manual intervention, enabling faster decision-making, and accelerating claim resolutions.
- OptiSol’s machine learning-based solution improved fraud detection, preventing cybercrime, lowering overhead costs, and enhancing the client’s ability to detect fraudulent claims.
Problem Statement
01
Unlabeled Data: The client’s claims data lacked labels to identify whether a claim was fraudulent or genuine, posing challenges in detecting anomalies.
02
Manual Review: Existing mechanisms relied on manual review processes, which were time-consuming, inconsistent, and unable to effectively handle large volumes of claims.
03
Fraud Prediction: The client required a solution capable of analyzing claim details filed during the process and predicting the likelihood of fraud with accuracy and efficiency.
Solution Overview
01
A thorough evaluation of the client’s existing policies, mechanisms, and regulations was conducted to identify potential gaps in detecting fraudulent claims.
02
Comprehensive data analysis was performed to examine key variables and detect abnormalities or inconsistencies indicative of potential fraud.
03
The time duration between the accident occurrence and the claim filing date was scrutinized to identify delays or patterns that could signal fraudulent activities.
04
Driver-related factors, such as license classification, driving experience, and vehicle restrictions, were analyzed and visualized to identify unusual patterns and potential red flags.
05
Advanced machine learning models, including Isolation Forest and Support Vector Machines (SVM), were developed to identify and flag anomalous claims, enabling the detection of potential fraud.
Business Impact
About The Project
OptiSol partnered with the client to address fraud detection challenges in their insurance process. We implemented AI and machine learning to automate fraud detection and streamline claim analysis, improving operational efficiency. By analyzing data variables and incorporating driver-specific factors, we identified anomalies using models like Isolation Forest and SVM. This solution reduced manual intervention, accelerated decision-making, and resulted in improved fraud detection, optimized workflows, and cost savings for the client.
Technology Stack
Testimonials of Our Happy Clients
Ken Kisner
Global Head of Digital R&D
My experience has been incredibly positive. They were incredibly easy to work with, even with changing requirements.
They are incredibly competitive, but are only a fraction of the cost of US companies.
They are definitely the most professional of the foreign companies that we were looking into.
Nyswyn K.
Director of Software Development
Our journey with OptiSol has been nothing short of remarkable. For over 7 years, we have partnered with them on our digital transformation, and the results have been truly transformative.
Over the years, we have come to trust OptiSol Business Solutions as a reliable and strategic partner.
Al Bagiro
CTO, Auto Insurance Company
The AI engine was completed on time and trained to 90% accuracy. Their eagerness to learn new knowledge impressed us.
Their team is large to handle multiple projects at once, and likes to resolve challenges as well as learn new things. They also welcome regular communications, and of course, needless to say, develop everything in sprints.
Dan Talken
Founder, CEO, & CTO, My Equipment Library, LLC
OptiSol Business Solutions has shown youthful skill and dedication to the projects. Moreover, they have been quick to implement their solutions without sacrificing the quality of each platform.
We’re constantly impressed with their speed and quality of the development that they achieve on a consistent basis.
Dr. A.K Pradeep
CEO MachineVantage
Exceptional Collaboration and Expertise - A Top-Notch Partner for AI, ML, and Digital Applications.
I have had the privilege of working with an exceptional team of professionals from India on numerous AI, ML, and digital application projects. Their expertise in these domains is remarkable, and they consistently impressed us with their knowledge, resources, and innovative approach.
Rick Tigges
CFO, Bemodo
They are very responsive and able to shift focus quickly as we have needed it for business reasons.
OptiSol Business Solutions has been great at documenting the timeline of the project. They were very responsive and were able to shift focus quickly, as well. They discuss what they’re working on without any issues. So far, there’s no need to improve their service.
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