The adoption of predictive analytics for fraud risk mitigation within life insurance anti fraud programs continues to grow. Predictive analytics is currently in use to identify potentially fraudulent claims at both the post policy issuance and claims stages.
Predictive models utilize machine learning from historical data to provide an on-going pattern analysis for fraud investigators. These patterns can then be used to flag high risk proposals, policies and claims that can be further investigated to ascertain fraud.
Nirmal Paul, CACM, Head Fraud Prevention Unit at Bajaj Allianz Life Insurance, Dr. Nilesh Karnik, Chief Data Scientist, and Jackie Vergne, Director of Customer Success from Aureus Analytics discussed how predictive analytics can be successfully implemented within a fraud mitigation process.
Head - Fraud Prevention Unit, Bajaj Allianz Life Insurance Company Ltd.
Nirmal is a seasoned professional with rich 20 years of experience in Financial Crime, Building and institutionalizing Culture of Ethics and Compliance, Forensics Investigation, Fraud Risk
assessments, Predictive Data Analytics, Fraud Risk Management, Code of Conduct, Whistle Blowing Process, Prevention of Sexual Harassment, and Compliance Audits.
In his current role as Head of the Fraud Prevention Unit at Bajaj Allianz Life Insurance, Nirmal leads an innovative anti-fraud program that uses prediction and detection to proactively identify fraudulent activity on a daily basis.
Nirmal is passionate about fraud awareness and insurance industry collaboration at various industry levels.
Chief Data Scientist, Aureus Analytics
Dr. Karnik is responsible for the development of algorithms and mathematical models that power Aureus' platform and products which help large organizations with advanced analytics solutions.
Nilesh holds a Doctorate in Electrical Engineering from University of Southern California (1998). His PhD dissertation made a substantial contribution to the theory of Type-2 Fuzzy Logic Systems and his work is still widely referenced.
In 2015, Analytics India magazine named Nilesh one of the top 10 data scientist to watch.
Director, Customer Success, Aureus Analytics
Jackie is a senior operations executive with over 20 years of experience in global multi-line property and casualty insurance companies.
She has made significant contributions by strengthening the financial, competitive, operational, and client service performance of insurance businesses.
In her previous roles, Jackie held various operations and underwriting positions with Franklin Mutual Insurance, Swyfft, Duck Creek Technologies, Chubb, Selective Insurance, Fireman’s Fund, and State Farm.
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