How to Modernize the Core System While Simultaneously Beginning the Fight Against Fraud

SURA Colombia web image
SURA Colombia web image
SURA Colombia web image
SURA Colombia web image

Customer
SURA Colombia

Challenges

  • Integrity of information

  • Modifying a manual procedure, based on the adjuster’s instincts

  • Modernizing the core system while simultaneously beginning the fight against fraud

Solution
FRISS Claims Analytics

Customer

With 75 years of experience, this branch of Suramericana S.A. offers a wide portfolio of insurance policies. It also provides services that increase customer wellbeing, and offers sustainable competitiveness to over 12 million unique clients by managing trends and risks. Its lines of business include life and general insurance, encompassing policies that are both voluntary and those that are compulsory. SURA Colombia’s value proposition is complemented by offering health services and diagnostic support, as well as consultancy and technical assistance.

SURA Colombia is the leading insurance company in Colombia, with a 24.3% share of the market at the end of 2019.

Challenge

SURA Colombia’s claims procedure was manual and based on the adjuster’s instincts. They were in charge of identifying any inconsistencies in elements of the story, or the even the story as a whole. At best, maybe there would be another version, similar to other fraudulent claims they had seen in the past, which could generate alerts and trigger an investigation.

There was a need for greater information and a technological tool that would help them through this process. It is, for this reason, they sought out FRISS to help them facilitate detecting fraud.

Solution

A number of providers were evaluated, ultimately leading SURA Colombia to choosing FRISS. One issue FRISS could tackle was that of a seamless integration with SURA’s core system. The second was the necessity for a tool that works 100% in the cloud, and offers a highquality service in real time. Thirdly, FRISS is a company with 100% focus on fraud, and therefore regarded as an expert on this topic. The knowledge about processes in the insurance industry, combined with predictive analysis and artificial intelligence models, as well as the possibility to integrate external information to strongly enrich the process stood out to SURA. On top of this, FRISS improves the service times for their customers’ customers, too, keeping everyone happy.

Because of the multitude of these benefits, FRISS was chosen as their fraud detection tool. At present, FRISS is also connected to a number of external sources in Colombia, which makes it possible to dynamically improve the precision of alerts and models.

Thanks to the FRISS solution, SURA Colombia will now be able to rapidly take care of claims that do not show signs of fraud. This will benefit not only our company, but also, and more importantly, our clients.

Risk Manager

Results

The implementation of FRISS was successful and they were able to deal with the integration of the information, solving SURA’s two main challenges. Information is not only crucial for the process to be successful, FRISS could do this while the insurer’s core system was being modified, too.

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