Speech recognition helps insurance company detect fraud

Challenge

Insurance companies must prioritize when investigating claims because not all submitted cases can be verified. The damage report of the reporting party is a valuable resource for the assessment of the case, and the assessment usually requires many years of experience. A large German insurance company faced the challenge of needing to process claim reports more efficiently.

Solution

To make the processing of claims more efficient, a voice-based tool was developed to assist claims handlers. For this purpose, a large volume of claims reports was combined with the assessments of experienced claims handlers and the outputs of investigations looked into. Using this data, a Natural Language Processing model was trained to detect fraud attempts with significant precision. The damage reports marked in this way are processed with special attention in the further process.

Added value

  • 70% of fraud cases were identified in the test set

Highlights

  • Data from damage reports from over 15 years
  • Extensive validation against retained data
  • Tuning of the classification model according to the wishes of the claims handlers
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