Fraudulent Claims

This Tableau Accelerator allows you to:

• Assess & Reduce your exposure to Fraudulent Claims
• Identify top offenders
• Deep-dive at Broker level of detail
• Drill-back at “Claim #” level of detail, directly in your Claim Application and take immediate actions

Demo video

Answer key business questions

• How are we exposed to Fraudulent Claims?
• Which Product Groups are affected the most by Fraudulent Claims?
• Which Brokers have exposed us most to Fraudulent Claims?

Monitor and improve KPIs

Claims

• Number of Claims: Total number of claims opened over the period
• Number of Suspected Fraud Claims: Total number of suspected fraudulent claims over the period
• Suspected Fraud Claims %: Share of claims which are suspected to be fraudulent (expressed in %)
• Average Policy Limit: Average of highest amounts the insurer will pay for claims covered by insurance policies over the period (expressed in currency)

Claims Amount

• Total Suspected Fraud Amount: Total amount paid for suspected fraudulent claims (expressed in currency)
• Suspected Fraud Amount %: Share of paid amount which is suspected to be fraudulent (expressed in %)
• Total Claims Amount: Total amount of compensation paid over the period (expressed in currency)

Required attributes

• Event Date (date): Date on which the event causing the damage or loss occurred
• Claim Number (string): Claim Unique Identifier
• Product Group (string): Group of the insurance product (Professional, Property, Technology, Vehicle, ...)
• Broker (string): Broker identified for this insurance policy, if any
• Policy Holder (string): Owner of the insurance policy
• Suspected Fraud Flag (string): Determines whether a claim is suspicious. Expected values: “Y”, “N”; “Y” means that the claim is suspicious.
• Policy Limit (numeric): The highest amount the insurer will pay for a claim that an insurance policy covers
• Paid Claim Amount (numeric): Total paid amount by the insurance provider for the claim