generali - fraud analytics

© Generali Deutschland Schadenmanagement GmbH

Fraud Analytics

Berlin, 27th February 2018

Neo4j GraphTour

Thorsten Gomann


1

Agenda

Generali Group

Insurance Fraud

Fraud Detection

Solution based on neo4j

Fraud Analytics / 2018-02-27 / Special Claims Department


2

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



3

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



4

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 %



5

Agenda

Generali Group

Insurance Fraud

Fraud Detection




6

Insurance Fraud

Exploitation

Fictitious Claims

Staged Claims



7

Agenda

Generali Group

Insurance Fraud

Fraud Detection




8

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



9

Agenda

Generali Group

Insurance Fraud

Fraud Detection




Generic Process for Fraud Detection based on Analytics10



Technical Integration11

Operative Sources

Stage

Analytics ViewGraph-Model

Fraud Analytics


{RESTful API}


Administration for automated Scenarios12



Casetool Frontend13


© 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

[email protected]

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generali - fraud analytics

Technology