The document discusses the problem of double-dipping fraud in the insurance industry. It describes double-dipping as filing a single insurance claim with multiple companies. It then summarizes the ClaimShare solution, which uses distributed ledger and confidential computing technologies to match claims based on non-personal data in order to detect fraud while maintaining privacy. ClaimShare processes the personal data of similar claims within a secure enclave to confirm fraud matches without exposing client information. The document claims this approach can reduce insurance fraud by 10% while complying with regulations and limiting IT investments for insurers.
2. Confidential and proprietary, IntellectEU 2022. Do not share.
What is double-dipping?
● Double-dipping relates to
filing a single claim with two
or more insurance
companies.
● Fraudulent individuals or
crime networks with 3rd
parties involved.
● Double dipping happens
within and across business
lines: problem difficult to
quantify
Double-dipping problem | (un) Detection of duplicate claims
Standard solution:
central databases
● Insurance industry and
association organize
centralized data sharing of
claims and/or PII-Data.
● Multi-party governance and
substantial IT and security
investments: focus on car
insurance.
● Data Quality problems: data
minimization and use case
limitation.
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Double-dipping problem
● According to KPMG up to 10%
of all insurance fraud is related
to Double Dipping
● IASIU 2019: 22% of all
insurance claims are
fraudulent.
● Global non-life insurance
written gross premiums : $ 3,5
Trillion.
● Avg Loss Ratio: 60%.
Estimated Duplicate Claims
Fraud: $ 40 Billion
3. Confidential and proprietary, IntellectEU 2022. Do not share.
Double-dipping problem | Insurance industry
Double Dipping stories
Car Insurance
Disability & Health insurance
Workers’ compensation
Pet insurance
Yacht insurance
➔ 16 insurers, € 400,000
➔ 3rd parties: garages, witnesses
➔ 5 insurers, € 1,000,000+
➔ 3rd parties: N/A
➔ 2 insurers, $ 85,000+
➔ 3rd parties: N/A
➔ 2 insurers, £ 8,358.50
➔ 3rd parties: veterinarians
➔ 11 insurers, € 1,700,000
➔ 3rd parties: claims experts
ClaimShare success story
➔ ClaimShare processed 700 claims related to workers
compensation business line from 5 Insurers for an european
region during a backtesting program during 2021.
➔ 100% of all duplicates were detected.
➔ Backtesting performed under 40 mins ( 17 Claims / minute).
➔ 2% of all claims (14/700) where detected as duplicate.
➔ ClaimShare would have saved the insurer €2.7 million within
only the pre-selected data.
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Double-dipping problem | Central DBs are not the solution
Risk illustrations from European countries
● On hold for 1 year due to regulatory
concerns on privacy & collusion: substantial
changes.
● Over 6 years of governance: data
minimization with scalability problems and
use case limitation.
● Manual checks and insurers’ consent
requests: focus on large claims, reduced
claims CXp and limitation of use cases.
Risks for the insurers
● Substantial and unpredictable IT investments
without quantified benefits.
● Sharing of personal and competitive data.
● Limitations in scalability, use case and business
lines expansion & claims customer experience.
Risks for the central database organization
● Board liability for data loss, breach or hacks
● (GDPR: fines for data breach up to 4% of
revenues).
● Central database maintenance, upgrades &
costs.
● No/minimal data available for overall
reporting/analysis.
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ClaimShare | Confidential computing
Confidential Computing provides assurance to users that data is processed as described and in a tamper proof way
Existing Encryption
NEW
Data at rest Data in transit Data in use
Protect/Encrypt data that is
in use during computation
Encrypt data during transfer
Encrypt data that is stored
NEW
Until today, it was not feasible to exchange claims and personal data
between insurers, while maintaining personal privacy and business privacy.
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6. Confidential and proprietary, IntellectEU 2022. Do not share.
ClaimShare | Data classification
NEW
Claim / FNOL
Data provided during underwriting
and FNOL
Car Insurance example
● Name, address, id..
● License plate
● VIN, Make/Model,..
● Coverage info
● …
Public Data
● Make/Model...
● Coverage info
● …
ClaimShare SPLITS the claims data
1. Personal Identifiable Data (PII)
2. Public Data
At no time does another insurer,
IntellectEU, or any other 3rd party have
access to this personal data.
Personal Data (PII)
● Name, address, id..
● License plate
● …
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7. Confidential and proprietary, IntellectEU 2022. Do not share.
ClaimShare | Architecture
NEW
ClaimShare uses R3 Corda distributed ledger
technology to share only non-personal identifiable
information between insurers, making it GDPR-
compliant.
Our proprietary artificial intelligence engine detects
suspected fraud by matching non-personal
identifiable information from claims, making
ClaimShare highly efficient and scalable.
To confirm suspected fraud, ClaimShare employs
hardware-based confidential computing to fuzzy-
match the private data of the most similar claims,
without exposing or storing client information.
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8. Confidential and proprietary, IntellectEU 2022. Do not share.
ClaimShare | How it works
NEW
Public Data
● Stored on-ledger
● Shared with all relevant parties
“ClaimShare solution is both from a privacy and a security perspective
in line with KPMG’s data protection requirements”
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Personal (PII) Data
● Stored only on insurer’s infrastructure
● Encrypted locally & protected during transit via
SSL
● Data protected using Hardware
● GDPR-compliant
ENCLAVE
R3 CORDA
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ClaimShare | Business Lines - Examples
NEW
Non-life insurance
Life insurance
Commercial insurance
Niche
● Life insurance
● Health
● Vehicle & Transport
● Property & Home insurance
● Travel insurance
● Credit insurance
● Loan insurance
● Valuable items
● Yacht insurance
● Personal accident insurance
● Limited Liability
● Disability
● Pet insurance
● Workers’ compensation
● Professional/Commercial Liability
Let’s discuss how can ClaimShare improve your industry specific processes
while maintaining personal privacy and business privacy.
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10. Confidential and proprietary, IntellectEU 2022. Do not share.
Limited IT Resources
False Positives
Data & Quality
Standards
● For public data, data cleaning and standardization can be provided. Inside the
enclave for fuzzy matching, we use part of the levenshtein-damerau algorithm as
well as proprietary logic. E.g. for matching different vehicle databases.
● By including a feedback loop between the private data matching and public data
comparison, the system further improves in detecting suspicious fraudulent
cases. A feedback loop between SIU results and ClaimShare can be integrated.
● Build your business case through a Backtesting program with a limited
investment in IT-resources. ClaimShare can fully host the common components
as well as your personalized secure environment for uploading historical data.
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ClaimShare | Acting on the Main Industry Concerns
11. Confidential and proprietary, IntellectEU 2022. Do not share.
ClaimShare | Benefits for the Insurance Industry
10% reduction in fraud
In all claim values
Extensions
Integration with 3rd parties and data
providers
Leading Technology Partners
Built with IntellectEU, R3, Intel, MS…
Regulatory Compliance
Compliant with industry and
governmental regulations
Detect in Real Time
Prevent fraud in real time - Increased
customer experience
Limited IT investments
No central Database implementation
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Steven Eliaerts
ClaimShare Product Manager
steven.eliaerts@intellecteu.com
THANK YOU
Jonathan Mayeur
ClaimShare Tech Lead
jonathan.mayeur@intellecteu.com