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SAS Assists Mexican Insurer in Fight Against Fraud

Staff Writer | July 08, 2014

Mexican auto insurer Quálitas will be using anti-fraud software from SAS to safeguard both the company and its customers from suspect activity. With SAS Fraud Framework for Insurance, the insurer will detect and prevent fraud early to reduce costs and optimize claims handling.

With its new SAS fraud platform, Quálitas expects to prevent big losses through timely detection of suspect activity and by integrating extensive data to zero in on suspects. And by reducing false positives, SAS frees investigators to focus on fraudulent claims with the most impact on the business, which increases efficiency.

“SAS technology delivers a single view of our customers and helps us capitalize on our data to improve fraud detection and prevention,” says René Abdala Mirwald, director of strategic planning and operational efficiency at Quálitas. “As a result, we’ll continue generating quality customer service.”

Using SAS Fraud Framework for Insurance, Quálitas will accelerate the claims payment process by quickly identifying suspicious claims and promptly serving legitimate ones, keeping customers satisfied. SAS will help the insurer evaluate all claims using consistent statistical and analytical criteria, rather than depending on an individual adjuster’s experience or instinct to identify suspicious activities.

Quálitas expects to discover more organized fraud rings across business lines and deter fraudsters from targeting the insurer.

“First, we will use SAS to decrease fraudulent insurance claims. We then plan to implement it internally to further reduce costs while nurturing our customers’ loyalty,” said Abdala.

“Research shows that up to 20 percent of claims may be fraudulent,” said Raquel Guillot, fraud domain expert at SAS. “That makes insurance fraud a worldwide problem with a huge financial impact, both on an insurer’s bottom line and as an impediment to competitive rates.”


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