How Did El Aguila Achieve 50% Decrease in Time Spent on Policy Applications and Claims
Customer
Seguros El Aguila
Challenges
Only 10% of all suspicious cases could be evaluated through their homegrown legacy systems, and otherwise by gut feeling
Difficulty in analyzing historical information to generate a fraud baseline
Lack of external information integration
Solutions
FRISS Claims Analytics
FRISS Underwriting Analytics
Results
75% reduction of false positives
50% decrease in time spent per policy application & claim
Implemented fast-track processing for acceptable risks
Customer
El Águila, Insurance Company, S.A. de C.V., is a company owned by Great American Insurance Group, a member of the American Financial Group (AFG). AFG is rated A+ by A.M. Best, with shares listed on the New York Stock Exchange, and assets of over 13 billion dollars. El Águila specializes in car insurance, operating in the Mexican market, tailoring their offerings to match customers’ unique insurance needs.
Challenge
Seguros El Águila used to build and expand their applications internally. They recognized that at some point this system would not be comprehensive enough to check all claims, and only in specific situations would they be able to reviews suspicious cases. Unfortunately, information was regularly lost and nothing was done to investigate cases further.
At best, El Águila could only assess 10% of their 3,000 monthly cases; they weren’t sure if the remaining 90% were legitimate or not. As they relied a lot on experience from their staff, there was no method to scale and screen all claims in a standardized and unbiassed way.
For the claims that were screened, El Águila noticed they didn’t have an adequate system in place for data analysis or claims history. They needed more background information from previous cases and wanted to build a deny list they could use for future claims.
Selection
The main factor in El Águila’s decision to select FRISS, was that it’s not just an end-to-end automated fraud analytics solution. FRISS has an impact at all levels, at all stages of the underwriting and claims processes. Its innovative technology makes the entire operation more efficient.
“Fraud is dynamic and one very interesting thing about the FRISS solution is that it uses artificial intelligence, specifically through machine learning, data mining and data analysis to review the adjusters’ reports, and when we are assessing an accident, it evaluates claims reports.” Enrique Morales CEO of El Águila
During the onboarding process, the FRISS algorithms were tailored to the Mexican market in particular, using the local experience of El Águila employees and the needs of the market as a whole. This also made it possible to integrate already existing external databases.
El Águila’s data is constantly reviewed and evaluated, allowing algorithms to be consistently recalibrated and tailored. Fraud itself is incredibly dynamic, so having a solution that can adapt to its ever-changing nature continues to be instrumental in El Águila’s success.