Alan_Haskins
Quantexa TeamJoined 3 years ago
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Why are some insurance companies pulling out of high-risk areas like Florida and California?
Insurance companies have seen an increase in costs associated with natural disasters, hurricanes, wildfires and rising litigation costs - all of which make it difficult to operate profitably in California and Florida. Many insurers are now reconsidering their decision to provide new insurance policies in these states due to the high levels of risk involved. To address this issue, insurance companies need to utilize a variety of strategies such as decision intelligence, customer intelligence, data strategy and advanced analytics in order to understand the full scope of their risk exposure. By leveraging predictive models, artificial intelligence and machine learning, insurers can develop a better understanding of customer needs and adequately assess risks before writing new policies. Additionally, increased transparency is necessary for insurance companies to accurately measure levels of frequency and severity and develop a complete understanding of risk. Through comprehensive data strategy and analysis, insurers can identify areas where policies are more likely to be profitable and allocate resources accordingly. Finally, it's important for insurance companies to consider the long-term implications of their decisions when choosing whether or not to write new insurance policies in California and Florida. Although there is a higher level of risk associated with writing policies in these states, the potential rewards may make it worth taking on the added risk. By utilizing a combination of strategies and making informed decisions, insurers can ensure their long-term success. Liberty Mutual to halt business owners policies in California Current policies will not be renewed after December144Views1like0CommentsRe: Poor data quality can hurt the insurance industry's ability to detect and prevent fraud
Recent conversations with industry data strategy and innovation experts have raised the alarm about data quality and transformation issues, which are hindering the consumer experience and eroding personal connections. So, how can we continue to drive digital innovation while prioritizing consumer needs and experiences?56Views1like0CommentsRe: How Synthetic Identities Are Impacting the Insurance Industry
Synthetic identification fraud has become a growing concern, particularly in the realm of health insurance. Criminals create fake identities using a combination of real and fabricated information or steal an identity then pose as the legitimate policyholders in order to obtain medical benefits. By operationalizing internal data assets and accessing external data sets fraud prevention protocols can be put in place at the application and point of sales through to FNOL. In my opinion application fraud is the most undetected insurance fraud. How can you protect against application fraud? Focus on strong identity proofing tools for customer intelligence Real-time entity resolution and verification protocols Enrich internal and external with analytics and scoring models Identify social media and online presence Validate with ID verification and documentation or biometrics As soon as we think we've figured out how the criminals figure out new ways to commit fraud!32Views0likes0CommentsHow Synthetic Identities Are Impacting the Insurance Industry
Synthetic identity theft involves creating a new identity from pieces of real and false information. Fraudsters often use real Social Security members (SSNs) combined with fake names and addresses to create these “synthetic” identities. These fraudulent profiles can be used to open credit card accounts, apply for loans, or even take out insurance policies. The challenge for insurance companies is that these synthetic identities often go undetected until it’s too late – by which time the fraudster has already taken out the policy or service using the stolen identity. The best way for insurance companies to combat synthetic identities is by implementing an enterprise-wide digital strategy that validates customer data at the point of collection in real time. This could include requiring customers to provide additional forms of identification and validation of signatures, personal identifiable information and documentation of records when applying for coverage. Additionally, insurers should monitor accounts regularly for suspicious activity and use entity resolutions and artificial intelligence and machine learning technology to identify patterns that may indicate fraud. In addition to utilizing advanced analytic and fraud detection solutions, companies should focus on training employees on how to spot signs of potential identity fraud and what steps they should take if they suspect fraud in occurring on a policy, claims, or account. Synthetic identity fraud is becoming increasingly common in the insurance industry and can be difficult to detect without the right technology in place. Fortunately, there are steps insurers can take to protect their business, customers, and insureds from this type of fraud – such as using advanced entity resolution technology, network generation and perpetual customer monitoring for suspicious activity – to ensure that only legitimate customers area able to access their policies, accounts, and services. By taking proactive steps now, insurance companies can reduce their risk of falling victim to synthetic identity fraud.290Views1like4CommentsRe: The insurance single customer view.. What actually is it ?
I think people miss use the term entity resolution. We have all heard insurers wanting to achieve a customer “golden record” they can have confidence they have created a record of an individual that all future decisions can be based. But insurance companies lack the ability to truly connect siloed data across systems and platforms that were never meant to be connected. And if they’re able to create a record that resembles a golden rerecord it’s a snapshot in time of the individual you are trying to quote a price, underwrite a policy, or base a claims-decision on. True entity resolution provides confidence that you built a 360-degree view of your customer, applicant, insured, claimants, or third parties, that can be regenerated in real-time as additional data is dynamically brought into the system. Entity resolution is not a one and done customer view it’s an ever-changing target that sometimes does not want to be identified.51Views0likes0CommentsRe: Insurance data privacy & ethics - how far does the market need to go?
Earlier this year I spoke at the National Association of Insurance Commissioners (NAIC) Insurance Summit, and after receiving a question about the ethical use of consumer data and if insurance companies should be allowed access and use consumer data for rating, underwriting, marketing, and claims processing. I simply asked, how quickly and accurately do you want your claim paid? How quickly do you want your application processed, receive a quote and policy? I explained the same data is used to process and pay 98 percent of all insurance claims across all lines of business is the same data used for analytics to identify, prevent, and deny questionable or fraudulent claims. The same consumer privacy advocates want claims paid more efficient, electronically and with a better customer experience. Consumer data is used to validate claims the vast majority of the time then it is used to deny a claim.42Views0likes0CommentsRe: Insurance data privacy & ethics - how far does the market need to go?
U.S. Federal laws such as HIPAA and Gramm-Leach-Bliley have carve-outs for the use of personal consumer data for fighting insurance fraud and prevention, in turn the current enacted state consumer data privacy laws have exemptions and exceptions to those federal statutes. As long as those same exemptions and exceptions are in future state privacy laws insurance companies will have the ability to access and operationalize actionable intelligence from consumer data sources.34Views0likes0CommentsRe: Insurance data privacy & ethics - how far does the market need to go?
With the lack of a comprehensive U.S. Federal data privacy law means we are left with a patchwork of confusing and jurisdictional challenging state laws. Four states California, Colorado, Connecticut, Virginia, and Utah passed comprehensive consumer data privacy laws and twenty-seven other states have introduced and are in different stages of becoming law. The concern and confusion come from the number of consumer rights and business obligations insurers must navigate, implement, and establish to comply with those new individual state laws and regulations. A national insurer licensed and admitted offering multiline insurance products in all fifty states has consumer data in multiple locations across multiple jurisdictions in multiple systems in the cloud and on premises. With billions of records spanning decades, stored within outdated legacy systems including sales, quotes, underwriting, claims, and payment data makes complying with every state consumer right to access, restrict, op-out, delete a dauting task for even the most sophisticated compliance, IT and data science staff.33Views1like0Comments
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