System for dynamic fraud detection
US-2016110818-A1 · Apr 21, 2016 · US
US12530724B2 · US · B2
| Field | Value |
|---|---|
| Publication number | US-12530724-B2 |
| Application number | US-202117493686-A |
| Country | US |
| Kind code | B2 |
| Filing date | Oct 4, 2021 |
| Priority date | Mar 26, 2015 |
| Publication date | Jan 20, 2026 |
| Grant date | Jan 20, 2026 |
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Signals-based data syndication and collaboration is disclosed. A data store of insurance related data collected from a plurality of carriers is accessed. A pattern is identified based at least in part on data stored in the data store. The pattern is associated with a first set of insurance related data belonging to a first carrier and with a second set of insurance related data belonging to a second carrier. First and second users associated with the first and second carriers are notified, respectively, of the identified pattern. Consent from the first user to share at least a portion of the first set of insurance related data and consent from the second user to share at least a portion of the second set of insurance related data are obtained. At least a portion of the second set of insurance related data that the second user has consented to share is caused to be presented to the first user. At least a portion of the first set of insurance related data that the first user has consented to share is caused to be presented to the second user.
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What is claimed is: 1 . A system, comprising: one or more processors configured to: collect insurance related data from a plurality of carriers, wherein the collecting comprises initiating, based on a timer as part of a batch process, communication with a plurality of remote on-premise installations associated with the plurality of carriers, wherein the collected insurance related data is transmitted, over a network, via data extraction agents of the on-premise installations, and wherein the data extraction agents are configured to format extracted data into a standard form for processing by a centrally hosted component, including mapping fields named differently by different carriers to a same field on the centrally hosted component; store the collected insurance related data in a data store of the centrally hosted component, wherein the storing comprises: partitioning the collected insurance related data on a per-carrier basis; and securing the collected insurance related data at least in part by encrypting the insurance related data included in the data store; access the data store including the insurance related data collected from the plurality of carriers; based at least in part on an analysis performed across the insurance related data collected from the plurality of carriers: identify a pattern that is present in both a first set of insurance related data belonging to a first carrier and a second set of insurance related data belonging to a second carrier, wherein the pattern is identified at least in part by determining a similarity between characteristics of a first claim in the first set of insurance related data belonging to the first carrier and a second claim in the second set of insurance related data belonging to the second carrier; and in response to identifying the pattern that is present in both the first set of insurance related data belonging to the first carrier and the second set of insurance related data belonging to the second carrier, notify first and second users associated with the first and second carriers whose data is implicated in the identified pattern, respectively, of the identified pattern; and in response to receiving an indication of consent by the first and second carriers to collaborate, generate an investigatory data pool according to a collaboration configuration, wherein the investigatory data pool comprises information pertaining to the first claim and the second claim implicated in the identified pattern consented to be shared by the first carrier and the second carrier, wherein the information that is included in the investigatory data pool is determined based at least in part on information associated with the first claim and the second claim implicated in the identified pattern, and wherein generating the investigatory data pool comprises anonymizing at least some data included in the investigatory data pool; and cause to be presented to the first user and/or the second user the investigatory data pool; and a memory coupled to the one or more processors and configured to provide the one or more processors with instructions. 2 . The system recited in claim 1 , wherein the information consented to be shared by the first carrier and the second carrier is stored in the data store, and wherein the information consented to be shared by the first and the second carrier is copied from the data store to the investigatory data pool. 3 . The system recited in claim 1 , wherein the information consented to be shared by the first carrier and the second carrier is stored in the data store, and wherein the investigatory data pool comprises references to the information consented to be shared by the first carrier and the second carrier. 4 . The system recited in claim 1 , wherein the investigatory data pool is associated with a case object. 5 . The system recited in claim 1 , wherein notifying the first and second users includes making requests to the first and second users to share data pertaining to the pattern. 6 . The system recited in claim 1 , wherein the first user is presented, via an interface, data in the first set of insurance related data belonging to the first carrier that is relevant to the identified pattern. 7 . The system recited in claim 6 , wherein the one or more processors are further configured to receive a selection of at least some of the presented data, the selection comprising an indication of data that is sharable, and wherein the data indicated to be sharable is included in the investigatory data pool. 8 . The system recited in claim 1 , wherein the pattern is assigned a score indicating a strength of the pattern. 9 . The system recited in claim 8 , wherein consent to collaborate is automatically granted based at least in part on a comparison of the score against a threshold. 10 . The system recited in claim 1 , wherein the one or more processors are further configured to obtain validation of the pattern. 11 . The system of claim 1 , wherein identifying the pattern comprises determining, using machine learning, a score for the pattern, and wherein the first and second users associated with the first and second carriers are notified in response to the machine learning-determined score for the pattern exceeding a threshold. 12 . A method, comprising: collecting insurance related data from a plurality of carriers, wherein the collecting comprises initiating, based on a timer as part of a batch process, communication with a plurality of remote on-premise installations associated with the plurality of carriers, wherein the collected insurance related data is transmitted, over a network, via data extraction agents of the on-premise installations, and wherein the data extraction agents are configured to format extracted data into a standard form for processing by a centrally hosted component, including mapping fields named differently by different carriers to a same field on the centrally hosted component; storing the collected insurance related data in a data store of the centrally hosted component, wherein the storing comprises: partitioning the collected insurance related data on a per-carrier basis; and securing the collected insurance related data at least in part by encrypting the insurance related data included in the data store; accessing the data store including the insurance related data collected from the plurality of carriers; based at least in part on an analysis performed across the insurance related data collected from the plurality of carriers; identifying a pattern that is present in both a first set of insurance related data belonging to a first carrier and a second set of insurance related data belonging to a second carrier, wherein the pattern is identified at least in part by determining a similarity between characteristics of a first claim in the first set of insurance related data belonging to the first carrier and a second claim in the second set of insurance related data belonging to the second carrier; and in response to identifying the pattern that is present in both the first set of insurance related data belonging to the first carrier and the second set of insurance related data belonging to the second carrier, notifying first and second users associated with the first and second carriers whose data is implicated in the identified pattern, respectively, of the identified pattern; in response to receiving an indication of consent by the first and second carriers to collaborate, generating an investigatory data pool according to a collaboration configuration, wherein the investigatory data pool comprises information pertaining to the first claim and the second
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