SAS® Analytics fights fraud across industries

SAS joins the Association of Certified Fraud Examiners (ACFE) in promoting International Fraud Awareness Week

It’s a crime without borders that can emanate from anywhere in the world. Its many faces cost organizations a mind-blowing $3.7 trillion annually, and no industry is immune. We’re talking about fraud, of course, and the dawn of digital has only made it easier for fraudsters to hatch new schemes – but it’s also serving to unravel them. Armed with advanced analytics from SAS, organizations across the spectrum are using their growing data volumes to thwart would-be schemers.

“Organizations that lack anti-fraud controls suffer greater median losses – twice as much, in fact – proving the old adage that an ounce of prevention is worth a pound of cure,” said Greg Henderson, Senior Director of Fraud and Security Intelligence at SAS. “As a long-recognized leader in fraud analytics software, SAS helps organizations take a proactive approach to fraud prevention, so they can catch fraud sooner and minimize their losses.”

As a sponsor of the Association of Certified Fraud Examiners’ (ACFE) International Fraud Awareness Week, Nov. 12-18, SAS spotlights the global plague that is fraud and calls on businesses to educate and protect themselves from the evolving plots that threaten their bottom lines.

Global banks face down double trouble

When fraud hits a financial institution, fraud-related losses often come with hefty regulatory fines. In a 2016 SAS survey of 121 European and North American banks, one in five indicated they had been fined by regulators or law enforcement agencies in the past three years. Among those banks, 22 percent paid fines in excess of $1 billion. Facing losses on two fronts, 99 of the top 100 global banks are using SAS^® to ramp up their analytics arsenals.

“Advanced analytics and machine learning techniques need to be core components of an end-to-end fraud management program,” said Nikhil Aggarwal, a longtime analytics executive in banking, now fintech entrepreneur-in-residence at iValley Innovation Center. “Models help discover and predict previously unknown suspicious and fraudulent threats, minimize false positives, and help investigators zero in on the most risky fraudulent behaviors and activity early on. The benefits are both significant and tangible: Reduced fraud losses translate into positive P&L impact.”

Beyond the big banks

Smaller financial institutions face many of the same threats as big banks but are challenged to develop equivalent fraud-fighting capabilities. SAS and Jack Henry & Associates recently announced a collaboration that aims to change that, delivering the power of SAS Visual Investigator without the costly on-site deployment.

“Cloud-based JHA Enterprise Risk Mitigation Solutions™ empowers midtier banks and credit unions with industry-leading predictive analytics they once considered out of reach, merging anti-money laundering and fraud analysis into one collaborative interface,” said Ron Moses, General Manager of Consumer and Commercial Solutions at Jack Henry & Associates. “Early adopters like Boston-based Brookline Bancorp have already identified instances of fraud and abuse that might otherwise have gone undetected.”

Amica tackles fraud, takes care of customers

Insurers face a median $107,000 lost per fraud case, according to the ACFE. Amica, the oldest US mutual insurer of automobiles, relies on SAS to quickly surface suspected fraudulent activity and keep its customers happy.

“Ours is an industry where customer satisfaction is measured by the expediency of claims processing, and Amica prides itself on exceptional service,” said Ray Zientara, Business Intelligence Manager in Amica’s Claims Executive Department. “Our fraud analytics framework helps us direct investigative resources effectively and, importantly, without impeding the processing of legitimate claims.”

Getting government benefits to the people who need them most

The Government Accountability Office estimated the amount of improper payments in fiscal 2015 across 121 government programs was $136.7 billion, up $12 billion from the previous year. Federal and state government benefit agencies are challenged with dispersing benefits quickly while maintaining program integrity.

The Georgia Department of Public Health is using SAS fraud software to promote integrity in its Women, Infants and Children (WIC) Supplemental Nutrition Program and ensure benefits go to those who need them most. Georgia WIC is using analytics to help the agency uncover patterns indicative of potential fraud and improve referrals to its investigative partners. For instance, bordering states are sharing data with Georgia WIC, in the cloud, to identify people claiming benefits in multiple states.

Tackling fraud in health care

This summer saw America’s largest ever health care fraud takedown as federal authorities charged 412 people – more than a quarter of them licensed medical professionals – in schemes totaling $1.3 billion in fraudulent transactions spread out over 20 states. And that’s barely a drop in the bucket. Estimates of the true cost of health care fraud range from around $70 billion to more than $230 billion each year.

SAS is among the sponsors of this week’s NHCAA Institute for Health Care Fraud Prevention’s annual training conference, where Ben Wright, a Senior Solutions Architect in the Security Intelligence Practice at SAS, will present Using Analytics to Drive Payment Integrity and Reduce Fraud. The session will explore how government agencies and private insurers can use advanced analytics to spot errors, abuse and waste throughout the entire claims process and stop losses before they occur.

Follow the tag #fraudweek throughout the week to learn more about how SAS delivers proactive protection through advanced analytics, AI and machine learning.