Analytics Data Management
The insurance management companies apply a large number of controls and business rules in their insurance collection and settlement processes given the variety of products they offer through their distribution chain (partners) and the millions of subscribed customers they maintain. It is also a business very exposed to fraud.
The solution to be applied with Ceptinel Risk Manager is in support in cases such as the following:
To the Compliance Vigilance area, Ceptinel Risk Manager implements Customer Verification rules, monitoring policy information, subscriptions and payments in combination with blacklist information.
In Fraud Control Ceptinel Risk Manager monitors critical processes that have a high Fraud rate, as is the case of insurance charges.
Settlement of Claims
In the Settlement of Claims, rules are implemented on information managed by the unit of analysis: Requests for Payment of Claims, Policies, Clients. Ceptinel can determine the payment or non-payment of a policy based on the “scoring” rules of the client.