Overview

Recognised as Fraud Intelligence Team of the Year (2023) at the Insurance Post Claims & Fraud Awards, leading international legal firm DAC Beachcroft (DACB) continues its commitment to innovation with a Rainbird-powered upgrade to its Dataflag tool for tackling fraudulent insurance claims.

Challenge

Dataflag, DACB’s data washing service, helps clients predict potential fraud prior to insurance claim payouts. Demand for this service continues to grow rapidly. 

However, additional post-washing services, relying heavily on human expertise, are required to turn these predictions into actionable decisions. The current process required an overnight batch run to process all claims and a further manual application of human expertise and reasoning to the less than 3% of the claims overnight batch process flagged as potentially fraudulent. 

The latter manual process led to a mounting backlog of potential fraudulent cases and limited DACB’s ability to take on new clients. DACB’s ambition was to remove the backlog and take on new clients by applying their rigorous expert reasoning to all cases. To do this, they needed to upgrade Dataflag with technology that can efficiently handle complex decisioning, reduce the existing backlog, reduce processing time, and support their expanding client base.

Solution

DACB turned to the Rainbird Decision Intelligence platform to address these challenges. Using Rainbird, DACB was able to capture and encode their vast expertise into extended knowledge graphs. The Rainbird Decision Intelligence platform reasons over the knowledge graphs to make decisions and provides detailed explanations for all claims, thereby eliminating the need for time-consuming manual checking. 

Additionally, Rainbird leveraged SS&C BluePrism to gather data, including fraud indicators, from multiple sources. 

To ensure sustainability, DACB’s subject matter experts (SMEs) were trained to expand the Rainbird knowledge graph so they could be self-sufficient in upgrading the solution. The Rainbird Decision Intelligence solution was designed with future adaptability in mind, allowing DACB SMEs to include new fraud indicators as they emerge.

This comprehensive approach enabled DACB to clear the existing backlog of cases within days of implementation.

Outcome

By implementing Rainbird Decision Intelligence, DACB is now able to process claims in real time, eliminating the need for overnight runs. Rainbird facilitated the digital application of human expertise to each claim, equipping the claims recovery team with comprehensive reasoning for each potential fraud case.

Brian Pearse, Chief Operations Officer – Claims Solution Group at DACB stated, “Embracing Rainbird Decision Intelligence is a testament to DACB’s commitment to innovation. This transformative step has led to a 500% increase in fraud detection and faster client onboarding. It’s a game-changer, enhancing our operational capacity and delivering superior outcomes for our customers.”

The newly implemented solution captures over 42 data points (up from 13), with the capability to include more in the future. Based on the largest data set received by a DACB client there has been a 500% increase in fraud detection and prevention.

This not only improved productivity but also ensured consistency and quality, significantly boosting their operational capacity to over 50,000 cases daily (an impressive 800% increase). Within the first week of use, DACB cleared their entire cases backlog, maintaining a high standard of work. This enabled DACB to onboard new clients faster, two within the first month alone, and grow their revenue, all while upholding their commitment to quality.

With the staff trained and capable of working with the knowledge graph, DACB are now self-sufficient in expanding the solution to include more fraud indicators when needed.