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James Taylor's Decision Management

James Taylor

Predictive analytics and fraud

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Insurance and Technology had a great set of posts on fraud detection and analytics - Emerging Technologies Fight Claims Fraud. In particular I liked the fact that they covered both the use of data mining and analytics to support investigation and the use of predictive analytics in individual transactions. While I tend to focus on the use of analytics in the context of transactions, there are many ways to use analytics in fraud detection:

  • Helping a human investigator understand what the data they have is trying to tell them
  • Helping a business owner understand cut-offs and thresholds that should be embedded in their business rules to route potentially fraudulent claims to investigators
  • Showing the impact of changes to the way claims are handled to avoid unexpected outcomes - like too many referrals for review
  • Calculating the probability that a specific transaction is fraudulent so that it can be dealt with appropriately
All too often people think that predictive analytics is just a fancy kind of reporting but it is much more than that.

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It is good thing that people are making use of technology to assist us in combating fraud. There are many kinds of fraudulent activities nowadays and it does not only occur with credit and medical records anymore. Unlike these documents that can be shredded by a Houston shredding company, digital data can be uploaded and shared worldwide. It has expanded to social networking sites as well as other software programs used in computers. This is why we need to be extra careful in handling our personal information.

James Taylor blogs about decision-management technologies such as predictive analytics and business rules, discussing how they deliver agility, improve business processes and bring intelligent automation to SOA.

James Taylor

James Taylor blogs on decision management for ebizQ, and is an independent consultant on decision management, predictive analytics, business rules, and related topics.

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