Grow Returns with AI-Generated Leading Indicators for Fraud Detection

Leading indicators are actionable variables strongly correlated with positive business outcomes. By tracking leading indicators, businesses can make proactive decisions to meet business targets and remain competitive. 

In spite of this, most organizations still leverage lagging indicators (KPIs, insights, etc.) to identify areas of opportunity for their next business cycle. At Daisy, we depart from this traditional paradigm – delivering granular leading indicators that can be actioned today for better results tomorrow.

In insurance, we use AI to deliver unique metrics that are leading indicators predictive of financial outcomes. By leveraging these leading indicators, insurers are empowered to make impactful decisions that uncover and eliminate fraud, waste, and abuse - generating significant financial returns by way of loss prevention and increased recoveries.

This blog will provide an overview of Daisy’s AI-generated leading indicators and how they are easily actionable to achieve significant financial outcomes.                      
          

How Does Daisy Generate Recommendations?

Daisy’s AI distinguishes between all the different peer groups – i.e., all the groups of individuals that possess similar characteristics - within an insurance business.

 Our system leverages the Daisy Suspicion Index to perform billions of comparisons and calculate the degree to which any individual, network of individuals, or claim differs from its peers (I.e., is an outlier) and is thus indicative of fraud. The Suspicion Index also scores entities on their level of suspicion – with a score of 1000 being the most suspicious. Entities with high scores and significant deviation across multiple peer groups represent fraud.

The Daisy system then generates alerts for highly suspicious entities and delivers them to the client via an online dashboard. Alerts are populated for each line of business at a rate that meets each organization’s needs – even as fast as real-time. Alerts are also populated using a score threshold that is selected by the organization.

Since Daisy alerts represent fraudulent activity, Daisy streamlines the investigative process by pointing insurers towards the entities that need the most attention – uncovering fraud before costly payments are made. Similarly, Daisy alerts insurers to entities that may have slipped through the cracks, increasing opportunities for fraud recoveries.

How Daisy’s AI-Generated Leading Indicators Deliver Results

As aforementioned, our Suspicion Index metric delivers alerts that guide insurers in making impactful investigative decisions. Our Suspicion Index is a leading indicator highly correlated to financial outcomes. It is also a leading indicator that is incredibly granular – i.e., at the level of the decisions insurers make every day. 

Decisions like: 
•    Is this claim fraudulent or not? 
•    Should this claim be paid or not? 

Since alerts with high suspicion scores represent the entities most likely to be fraudulent according to the Suspicion Index, accepting those alerts for investigation means insurers will proactively identify fraud and pay only genuine claims – boosting recoveries and minimizing fraud losses. In effect, insurers will be better positioned to meet financial targets and grow profits. 

Ultimately, our AI-generated leading indicators are easily actionable as insurers can simply accept our alerts for investigation to generate returns. Insurers that accept and investigate the alerts generated by the Daisy Suspicion Index will see significant financial outcomes – achieving a Return on Investment of 10X.

The Daisy system eliminates traditional lagging insights and instead guides insurers to make proactive decisions that will increase financial outcomes.

Insurers can identify patterns, trends, and correlations that would be impossible to detect without the use of AI. By leveraging our unique AI-generated leading indicators, insurers are empowered to make impactful investigative decisions that ensure only genuine claims are paid – eliminating fraud losses and increasing recoveries. 

Ultimately, by leveraging quality leading indicators, insurers are investing in their long-term success. Those leveraging the Daisy solution have the power to predictably grow their business – with the potential to see a Return on Investment of 10X. 

To learn how we can help you predictably grow your business, get in touch!