Deploying domain knowledge in the health insurance, workers compensation and compulsory third party insurance industries and state of the art data mining, management and visualisation techniques, this project seeks to identify the incidence of claims leakage (including fraud) in these industries.

To date the project has designed 300 rules and implemented 100. An initial trial over three months using 15 of the rules and applying it to 25% of 5 years of data has revealed significant savings as well as providing a range of broader insights into health insurance claims.

The next stage of the project is to expand the rule set and to determine whether the rules have similar value in other members of the Australian industry and in time the international marketplace.

The industry research partner is HCF.

For more details click here.