How a top legal practice revolutionised insurance fraud detection.

Need

DAC Beachcroft (DACB) – the international legal practice – faced critical challenges in insurance fraud detection:

• Necessity to upgrade their existing Dataflag tool for better fraud prediction and action.
• Mounting backlogs of potential fraud cases.
• Inefficient post-wash processes relying on overnight batch runs.
• Time-consuming manual analysis, with less than 3% of potential fraud cases scrutinised.
• Urgent need for technology to handle complex decisioning efficiently.
• Requirement to support a rapidly expanding client base.

Solution

DACB went in search of a solution and found Rainbird – an award-winning, AI-powered, decision-making platform. This Decision Intelligence (DI) tool delivers on 6 vital levels:

1. Captures and encodes DACB’s expertise into extended knowledge graphs.
2. Reasons over knowledge graphs to make pragmatic decisions.
3. Provides detailed explanations for all claims, eliminating manual checks.
4. Leverages BluePrism RPA tool to gather data from disparate sources.
5. Allows subject matter experts to expand the knowledge graph independently.
6. Is designed for future adaptability, enabling inclusion of new fraud indicators.

Value

The implementation of Rainbird’s DI platform delivered on many significant benefits:

• Real-time claims processing, eliminating overnight runs.
• 500% increase in fraud detection.
• Cleared existing case backlog within the first week.
• Increased data points captured from 13 to over 42.
• 6-fold improvement in fraud detection and prevention.
• 800% increase in operational capacity, handling over 50,000 cases daily.
• Faster client onboarding (two new clients within the first month).
• Enhanced consistency and quality in decision-making.
• Improved revenue growth while maintaining quality commitments.
• Potential for application in other areas of anomaly detection across various industries.

This case study demonstrates how Decision Intelligence can dramatically improve complex decision-making processes – particularly in fraud detection. This delivers significant operational and financial benefits.