An Insurance Company Achieves Dramatic Results with DataWalk

The Challenge

Kooperativa faced mounting pressure to enhance its anti-fraud capabilities while improving operational efficiency and key performance indicators. Despite its existing efforts, the company encountered several critical obstacles that hindered its ability to fully optimize its fraud detection and investigation processes. Specifically, Kooperativa sought to address the following challenges:

• Enhancing Anti-Fraud KPIs: Improving both detection and acceptance rates to better identify criminal activities and ensure accurate claim assessments.
• Data Silos Slowing Processes: Fragmented data across systems created delays in detection and investigations, demanding a unified approach to accelerate workflows.
• Lack of Automation: Manual processes in claims management were inefficient, highlighting the need for automated decision-making to streamline operations.
• Fraud Detection: The absence of advanced tools, such as network analysis, limited the company's ability to proactively detect fraud and anticipate evolving schemes.
• Dependence on External Scoring Calibrations: Reliance on third-party support for scoring calibrations restricted agility and delayed response times.
• Investigation Inefficiencies: Analysts lacked the tools to perform in-depth fraud investigations effectively, reducing their capacity to uncover complex fraud networks.
• Deriving Value from Relationships: Kooperativa struggled with fragmented data, hindering its ability to analyze data relationships, slowing the detection of organized crime networks, and limiting proactive fraud prevention.
  
  

DataWalk is essential for fraud investigations, anti-money laundering, and due diligence. It speeds up processes significantly, allowing for quick rule adjustments and scoring exports to the core system. Without DataWalk, everything would take much longer. ~ Zdenek Adamec, Chief Security Officer 

Kooperativa recognized the need for a transformative solution—one that would not only address these pressing issues but also future-proof its anti-fraud operations.

The Solution

Kooperativa partnered with DataWalk to revolutionize its anti-fraud operations, creating a transformative system that delivers agility, deep insights, and seamless scalability for tackling fraud. Leveraging the platform's advanced capabilities, Kooperativa has redefined how fraud detection and investigations are conducted, making the impossible achievable.

Highlights of the Solution:

• A Unified View of Fraud On A Single Pane Of Glass
  By integrating all data into a powerful Unified Knowledge Graph, DataWalk enables Kooperativa analysts to uncover hidden connections between claims, vehicles, people, addresses, contracts, email addresses, and phone numbers. This comprehensive 360-degree view helps analysts quickly identify and neutralize complex fraud networks.

It’s where I have all the data required for my investigation. I can easily see relationships between data sets and get results quickly. ~ Kooperativa fraud analyst 

Fig 1. A Unified View of Claim On A Single Pane Of Glass (example)

• Unparalleled Efficiency
  The DataWalk platform significantly accelerates processes that previously took months, enabling faster fraud detection and resolution.
  
  

We export scores from DataWalk to the core system. Implementing changes in DataWalk takes little time, making everything much faster. ~ Kooperativa fraud analyst 

• Seamless Expansion and Adaptability
  With DataWalk, Kooperativa seamlessly integrates external services like LexisNexis, effortlessly adding new data and use cases such as anti-money laundering and enhanced due diligence. This capability ensures that Kooperativa can expand its operations and address evolving requirements without requiring significant effort, demonstrating the adaptability and scalability of DataWalk’s platform.

DataWalk is perfect for clients like us, where we want a solution that will change a lot, add new data, and tune it with ease. ~ Kooperativa fraud analyst 

• Empowering Analysts with a No-Code Interface
  The intuitive no-code interface empowers analysts to explore data, generate no-code hypotheses, and adapt swiftly to evolving fraud tactics.
  
  
  

  Fig 2. Empowering Analysts with a No-Code Interface (example)

   

• Revolutionizing Investigations
  By leveraging network analysis and AI-based techniques, Kooperativa now operates with greater foresight and precision, transitioning from reactive responses to proactive fraud prevention.
  
  
• Efficient Architecture
  DataWalk performs computations directly where Kooperativa's data resides, minimizing data movement and complexity. AI/ML, graph analysis, and search run on a single computation component, ensuring efficiency and cost-effectiveness.

The Results

During the project, different analytical products were delivered that speed up the analysis and made the work of investigators easier and more efficient:

• Accelerated Analysis: Investigations are now 3x faster, with a unified 360-degree view ensuring no critical connections are missed.
• Hypothesis Testing: Instant querying and filtering eliminate hours of manual effort, enabling rapid validation of hypotheses.
• The context in scoring: Advanced analytical graph techniques deliver unified risk scoring, prioritizing high-value, high-risk cases effectively.
• Streamlined Triage: A centralized dashboard consolidates all claim details, reducing triage time and speeding up decision-making.
• Future-Ready Fraud Detection: Predictive models adapt scoring dynamically, achieving an acceptance rate exceeding 70%
  
  

DataWalk delivers breakthrough results for accurately detecting suspicious claims!  
~ Zdenek Adamec, Chief Security Officer