generali - fraud analytics
TRANSCRIPT
© Generali Deutschland Schadenmanagement GmbH
Fraud Analytics
Berlin, 27th February 2018
Neo4j GraphTour
Thorsten Gomann
© Generali Deutschland Schadenmanagement GmbH
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Agenda
Generali Group
Insurance Fraud
Fraud Detection
Solution based on neo4j
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
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One of the leading
insurers in the world
1 Fortune Global 500
International Generali Group at a glance
one of the world‘s
50 largest
companies1
more than
60 countries
in the world
74,000
employees
Pioneer in
Smart Insurance
Generali Group
530 billion Euro
Assets under
Management
70.5 billion Euro
in premiums (2016)
over 66% from outside
Italy
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
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Presence of the international Generali Group
Through Generali Employee Benefits, the
Group operates in more than 100 countries
Insurance operations of Generali Group
Branches: New York, United Kingdom, Hong Kong, Tokyo, Dubai, Panama
Other countries in which Europ Assistance operates
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
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Generali in Germany as part of the worldwide Group
GENERALI IN GERMANY
IS THE SECOND-LARGEST
COUNTRY UNIT
23% of the premiums of the Generali Group
€ 16.2 bn premiums in insurance business
€ 847 m operating result (FY2016)
12,400 employees
Branche: United Kingdom
23 %
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
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Agenda
Generali Group
Insurance Fraud
Fraud Detection
Solution based on neo4j
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
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Insurance Fraud
Exploitation
Fictitious Claims
Staged Claims
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
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Agenda
Generali Group
Insurance Fraud
Fraud Detection
Solution based on neo4j
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
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Approaches for Data Driven Fraud Detection
Rules based on experts
knowledge leading to probability
score
Create new (temporary)
scenarios
Rulesystem
Recognition of claims
participants in definedscenarios
Features derived from network
Social Network Analysis
File-Metadata
Manipulation
Data File Forensics
Textrecognition and
interpretation
• Keywords
• Connections
Semantic Analysis
Linear Regression
Logistic Regression
Decision Tree
Random Forest
Gradient Boosting
Neural Network
Support Vector Machines
Supervised Learning
Anomalyrecognition
Peer-Group Analysis
Clustering
Unsupervised Learning
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
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Agenda
Generali Group
Insurance Fraud
Fraud Detection
Solution based on neo4j
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
Generic Process for Fraud Detection based on Analytics10
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
Technical Integration11
Operative Sources
Stage
Analytics ViewGraph-Model
Fraud Analytics
Fraud Analytics / 2018-02-27 / Special Claims Department
{RESTful API}
© Generali Deutschland Schadenmanagement GmbH
Administration for automated Scenarios12
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH
Casetool Frontend13
Fraud Analytics / 2018-02-27 / Special Claims Department
© Generali Deutschland Schadenmanagement GmbH Fraud Analytics / 2018-02-27 / Special Claims Department
Thorsten Gomann
Data Scientist Fraud / Recovery / Litigation
Generali Deutschland Schadenmanagement GmbH
Gereonswall 68
50670 Köln
phone: 0221/1636-5645
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