Fraud Detection via Temporal Analysis of Documentation Submission
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Solution Overview
Problem
The submission of inaccurate or fraudulent documentation, particularly in insurance claim filings, is a significant issue due to the potential for digital images to depict damage that did not occur or be exaggerated, leading to increased costs for companies and consumers.
Innovation Solution
A computer-implemented method and system that analyzes initial documentation to determine if additional documentation is needed, initiates a communication channel with the user device to request necessary documentation, and assesses the submitted additional documentation for temporal compliance and potential fraud based on differences in submission times.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If digital images are accepted for insurance claim filings, then documentation submission is automated and facilitated, but the risk of fraudulent submissions increases
Solution Approach 1:
The system performs preliminary analysis of the initial documentation set to determine what additional documentation is needed before the claim is fully processed. This advance preparation prevents fraudulent claims from proceeding and reduces the risk of accepting inaccurate documentation.
Solution Approach 2:
The system establishes a communication channel that provides feedback to the user device about additional documentation requirements. This feedback loop allows the system to request and verify supplementary information, thereby reducing fraud risk while maintaining ease of submission.
2Measurement precision
If additional documentation is requested and analyzed, then fraud detection accuracy is improved, but processing time increases
Solution Approach 1:
The system determines the need for additional documentation through preliminary analysis of the initial submission, allowing it to request only the specific documents needed for fraud detection rather than requiring complete re-submission of all claim materials.
Solution Approach 2:
The system analyzes only the specific additional documentation needed to assess fraud risk rather than requiring complete verification of all claim elements. This partial action approach maintains adequate fraud detection while reducing overall processing time.
3Reliability
If temporal analysis of documentation submission is performed, then fraud detection capability is enhanced, but system complexity increases
Solution Approach 1:
The system automatically performs temporal analysis of documentation submission times without requiring manual intervention. The computer processor independently evaluates the timing patterns to detect potential fraud, reducing the need for complex manual review processes while enhancing detection capability.
Solution Approach 2:
The system replaces manual fraud detection mechanisms with automated computer processor analysis of temporal patterns in documentation submission. This substitution enhances detection capability while managing system complexity through algorithmic rather than manual processes.
Data Source
AI summary
Systems and methods for analyzing documentation for assessing potential fraudulent user submissions are provided. According to certain aspects, a server computer may receive an initial set of documentation descriptive of damage to a property asset, and may analyze the initial set of documentation to determine whether additional documentation is needed. The server computer may initiate a communication channel with a user device via which the additional documentation may be submitted, and the server computer may similarly analyze the additional documentation to determine a likelihood of fraud. The server computer may process the user submission accordingly.