IBM InfoSphere Software for Insurance and Health Plans

Fraud, Risk & Compliance

The Insurance industry is facing an ever-growing list of rules and regulations to comply with, and a shifting calendar of compliance deadlines to meet. Also, a growing percentage of insurance claims for property & casualty, life and health are fraudulent. This costs the industry millions of dollars per year. Huge insurance claims fraud and money-laundering schemes often involve sophisticated networks of fake insurers, doctors and lawyers. The challenges are only intensifying for businesses as fraud types and frequency multiply. Perpetrators are developing new strategies that target weaknesses in companies’ information infrastructure. All while insurers and health plans are under The Insurance industry is facing an ever-growing list of rules and regulations to comply with, and a shifting calendar of compliance deadlines to meet. Also, a growing percentage of insurance claims for property & casualty, life and health are fraudulent. This costs the industry millions of dollars per year. Huge insurance claims fraud and money-laundering schemes often involve sophisticated networks of fake insurers, doctors and lawyers. The challenges are only intensifying for businesses as fraud types and frequency multiply. Perpetrators are developing new strategies that target weaknesses in companies’ information infrastructure. All while insurers and health plans are under greater regulatory and profit pressures than ever.

IBM InfoSphere Software for Insurance and Health Plans provides a platform for companies to better manage their critical business information so they can improve protections from reputational and legal risk. By comprehensively managing customer identities and account information, firms can leverage their investments in risk and compliance for strategic advantage—enabling a single trusted view of customers while detecting potential fraud and more effectively meeting privacy and security regulations. At the core of IBM’s technology strategy is to provide best-in-class technologies that deliver a rapid return on investment, with a roadmap for the future. IBM’s comprehensive information management capabilities include master data management, master data integration, data warehousing and reporting, data quality management. In addition there are capabilities for sophisticated analytics, data management, and reporting. These, combined with IBM’s deep industry expertise, ensure that Insurance and Health Plan organizations get the right technologies and services to support fraud risk and compliance requirements, as well as IBM InfoSphere Software for Insurance and Health Plans provides a platform for companies to better manage their critical business information so they can improve protections from reputational and legal risk. By comprehensively managing customer identities and account information, firms can leverage their investments in risk and compliance for strategic advantage—enabling a single trusted view of customers while detecting potential fraud and more effectively meeting privacy and security regulations. At the core of IBM’s technology strategy is to provide best-in-class technologies that deliver a rapid return on investment, with a roadmap for the future. IBM’s comprehensive information management capabilities include master data management, master data integration, data warehousing and reporting, data quality management. In addition there are capabilities for sophisticated analytics, data management, and reporting. These, combined with IBM’s deep industry expertise, ensure that Insurance and Health Plan organizations get the right technologies and services to support fraud risk and compliance requirements, as well as business transformation and growth. Now and in the future.

InfoSphere Software for Insurance enables companies to:

• Improve Data Governance by improving data quality and data management across the enterprise
• Streamline financial reporting for a variety of enterprise risk management initiatives such as Sarbanes Oxley, Know Your Customer, and Solvency II, by assuring an accurate, timely, integrated view of information spread across many sources
• Leverage years of IBM experience in working with hundreds of insurance companies and health plans around the world
• Manage customer preferences, privacy, and do-not-call lists
• Quickly adjust to changing compliance environment and deadlines
• Enhanced Governance and data quality
• Centralize a real-time analytical repository to manage risk and compliance activities on a full integrated foundation