From Detection to Prevention: Risk-Based Predictive Analytics in Fraud Management

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Case Study
From Detection to Prevention: Risk-Based Predictive Analytics in Fraud Management

Industry: Government Agency

Challenge: Advancing Anti-fraud Capabilities

Solution: Predictive analytics, fraud detection, data management

Technology: SAS Enterprise Miner, Oracle, Python

Female Special Agent Works On A Laptop In The Background Special Agent In Charge Talks To A Military Man In The Monitoring Room. In The Background Busy System Control Center With Monitors Showing Data Flow.

Situation and Challenge

A government agency providing business support and subsidies sought to enhance its anti-fraud capabilities amidst increasing sophistication of fraudulent activities. The agency faced several challenges:

  1. Pressure to reduce fraud and waste in government programmes
  2. Optimising resource allocation to prioritise high-risk cases for investigation
  3. Adapting to evolving fraud patterns with a complementary solution to existing anti-fraud measures

Insight and Action​

Our approach included:

  1. Developing predictive risk scores using logistic regression and interactive binning techniques for robust predictive risk scoring
  2. Implementing a multi-step feature engineering process involving:

   – Data cleaning, transformation and normalisation

   – Feature selection and importance determination

   – Adaptive risk thresholding through binning

   – Model training, validation and refinement

  1. Integrating external data sources for contextual enrichment
  2. Natural language processing for unstructured data analysis
Results and Impact

Our intervention delivered improvements, including:

– Enabled prioritisation of high-risk cases for investigation, with 60% reduction in false positives

– €15 million in prevented fraudulent claims within the first year

– 30% improvement in early fraud detection, enabling proactive intervention

– Improved efficiency gains, contributing to future cost and resource savings

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