ITEC 5002 Week 7 Paper completed

Application of Data Analytics Tadrieka Collins Capella University ITEC 5002 Professor Chicone August 27, 2023
Overview of the Organization The NC Department of Insurance (NC DOI) regulates the insurance industry. Some of the department's duties include handling insurance related complaints and licensing insurance agents, adjusters, bail bondsman and more ( About DOI , n.d.). The NC DOI has a fraud sector known as criminal investigations division (CID). The CID conducts investigations and supports prosecution of insurance fraud perpetrators. The Problem or Need for Data Analytics The NC DOI was in need of data analytics due to insurance fraud. While the CID was already working to combat fraudsters, their records management system was outdated. This made investigations more complicated and forced employees to complete tedious and time- consuming administrative tasks ( Recovering Millions of Dollars in Fraudulent Insurance Claims via Advanced Analytics , n.d.). While coming up with a solution, the fraud continued to pile up, inflicting extra costs on insurance companies and increasing premium rates for consumers. In fact, the FBI estimates fraud costs the average family between $400 and $700 dollars per year in premiums ( Insurance Fraud , 2023). Data Analytic Method used to Solve the Problem The NC DOI chose SAS because it was the most suitable program for investigations. The NC DOI worked together with SAS to build a system to specifically aid the CID in investigating and prosecuting fraud. The system is called Insurance Crimes Investigation System (ICIS). The system uses SAS Visual investigator and SAS Visual Analytics to enable data intake and operational case management. ICIS allowed the CID to monitor trends in real timer, search and
retrieve information, conduct link analysis, and investigate every case that comes in. ( Recovering Millions of Dollars in Fraudulent Insurance Claims via Advanced Analytics , n.d.) The Outcome of the Application of Data Analytics By creating ICIS, the NC DOI recovered 6.9 million dollars after only seven months of implementation. In fact, the new system boosted investigator success rate from 60 percent to 98.7 percent. Before ICIS, cases took an average of 90 days (about 3 months) to close, however, the average now is less than 60 days (about 2 months). The new system is hosted in the SAS Cloud, allowing CID employees to get safe and secure access to case records wherever the internet is available. My Impression of the Application of Data Analytics Overall, the NC DOI did an excellent job implementing data analytics into their process and subsequently stop insurance fraud in its tracks. The first crucial step was recognizing that they needed a better system. With technology constantly adapting and changing, they were unable to keep up with the new ways people were committing insurance fraud. The systems they used also made investigating inefficient. SAS is an excellent choice that tailored a program specific to their needs. Considering the magnitude of the success that NC DOI had with ICIS, I would
Sources 1. About DOI. (n.d.). North Carolina Department of Insurance. %20North,adjusters%2C%20bail%20bondsmen%20and%20more 2. Recovering millions of dollars in fraudulent insurance claims via advanced analytics . (n.d.). SAS. 3. Insurance fraud. (2023, June). fraud#:~:text=Fraud%20not%20only%20inflicts%20extra,consumers %20%24308.6%20billion%20a%20year .
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