April 22nd, 2014; Mumbai: the bids of firms like IBM, Accenture have been shortlisted for Industry wide Fraud Analytics System by IRDA. The bids of Accenture Services, PricewaterhouseCoopers, IBM India and United Health Group Information Services have been found eligible under the Request for Proposal (RFP) for Industry wide Fraud Analytics System by the insurance regulator.
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The technical bid opening session will be held at Irda Hyderabad and a request has been brought out by Insurance Regulatory and Development Authority (Irda) for the proposal to set up an insurance fraud repository to reduce the costs of monitoring. This will be done by putting prevention systems and advanced detection in place at the industry level.
Irda said that this initiative will identify fraudulent claims before payment occurs at the claim processing stage and improve the fraud detection's accuracy. The insurers will be insisted with better screening of proposals at the underwriting stage and also in handling claims.
The regulator added that it expects from the system to ensure that the insurance companies were empowered to take informed decisions on claims and underwriting by using analytical and predictive capabilities. Thus, the payment and origination stages of the policy life cycle would be brought under the radar.
The project aims at the establishment of an industry-wide fraud database that will abolish the need for the individual insurance companies for setting up solutions of software and hardware at an entity level. A single repository of frauds would be created and maintained by the solution.
The complete characteristics and details of fraud would be captured by this repository. It will also facilitate seamless flow of such information among insurers/TPAs for the prevention of loss due to fraud.
Moreover, large amounts of data should be supported by the repository from all stakeholders in the health insurance system. It should also support real time, query-response ways of information exchange and online access of the application.
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