Right Decision Right Person Right Time Right Data ... smartC is a modus operandi based solution that...

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    17-Jun-2020
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Transcript of Right Decision Right Person Right Time Right Data ... smartC is a modus operandi based solution that...

  • Right Data Right Time

    Right Person Right Decision

  • Insurance Industry Challenges

    Industry Challenges Facing U.S. Insurers

    •Time-consuming process of gathering data

    •Timely closure of claims

    •Large Amounts of Claims Data

    •Varying Nature of Claims Data

    •Organized Crime

    •Maintaining Customer Relationships

    Infinilytics smartC™ •Automated data gathering and integration

    •Quickly segregates and validates questionable claims from genuine claims

    •Scalable SaaS-based technology

    •Works with internal claims and policy data, external data and social media sites

    •Modus Operandi based solution •Increases speed of service and claims resolution

  • DATA GATHERING DATA ENRICHMENT

    DATA ANALYSIS

    smartC – SaaS based web application that helps fast track genuine claims and flag

    questionable claims within minutes to help reduce claims expenses

    ● Internal Data ● Forms

    ● Social ● Link ● Medical ● 3rd party

    ● Claims Flagging / Fast Tracking

    ● Fraud scheme algorithms ● Claims Behavioral Patterns ● Risk Management ● Patent Pending ARM

    approach DATA ENRICHMENT AS A SERVICE (DEaaS)

    AUTOMATE D

  • smartC™ is a modus operandi based solution that combines data from internal and external data sources to quickly segregate and validate questionable claims from genuine ones.

    Pattern recognition with machine learning is combined with various analysis tools: • Text, structured and

    unstructured • Social media • Link • Medical (ICD9 & ICD10) • Business transaction rules

    Predictive modeling & forecasting