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Home » News » Next-Generation Insurance Fraud Detection System Built on Sparkling Logic SMARTS

Next-Generation Insurance Fraud Detection System Built on Sparkling Logic SMARTS


paper workInsuPector addresses problem of increasing fraud loss in Japan.

Sparkling Logic today announced that Blaze Consulting Japan, Inc., Tokyo, Japan, and Smart Logic Solution, Seoul, Korea have jointly developed InsuPector, a solution for insurance fraud detection for the Japanese Market, using Sparkling Logic’s SMARTS decision management platform. Claims leakage, including fraud, accounts for 10 to 16 percent of claim losses. Insurance fraud is a growing problem in Asia where total fraud in the auto insurance industry alone is estimated to be more than 10 billion dollars. “Each year billions of dollars are lost to insurance fraud and as a result customers face increasing rates. Fraud rings are getting more sophisticated and insurance companies need a comprehensive approach to identifying suspicious claims,” says Carole-Ann Matignon, Sparkling Logic CEO. “SMARTS provides an ideal solution by combining business rules and predictive analytics in an integrated offering and we are proud to be a part of the InsuPector solution.”


The majority of insurance fraud detection systems deployed in Asia mainly rely on statistics and analytics. But statistics and analytics require a sufficient quantity of fraud data to be effective. Frequently, even large insurance companies don’t have sufficient fraud data and it is almost impossible for small and medium sized companies to collect this data.

InsuPector, rather than relying on the amount of fraud data available, addresses this problem by combining analytics with rule-based fraud patterns based on more than 500 fraud patterns that can be extended to meet the companies specific needs and refined and improved through a built-in performance monitoring and feedback loop. Claim experts played a large role in the development, unlike many fraud detection systems, which were developed solely by engineers and data scientists. As a result, InsuPector is truly oriented towards improving overall business performance.

InsuPector is anticipated to increase fraud detection rates by at least 10 percent while giving insurance companies a significant improvement in their ability to prevent leakages and control and measure the claims process. By relying more on business rules, InsuPector enables improved business-IT collaboration and lowers total cost of ownership by allowing business experts to add custom rules as new products are added or new fraud cases discovered.“InsuPector effectively addresses the growing problem of fraud loss in the Japanese insurance market with the latest fraud detection technologies specifically addressing the needs of small and medium-sized insurers,” says H. Sako, Blaze Consulting, Japan CEO. Blaze Consulting Japan is currently working to deliver and install two systems with their SI partners with an estimated 5-6 month development time.

Additional Resources

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– Read Sparkling Logic Blog – http://blog. sparklinglogic.com.

About Smart Logic Solution, Inc

Smart Logic Solution, Inc. specializes in decision management technologies, providing consulting and engineering services to companies who want to improve their decision processes. Smart Logic Solution is know for their business-oriented solutions and professional services delivered to leading Asian companies.

Learn more about Smart Logic Solution at www.smartlogicsolution.com.

Blaze Consulting Japan, Inc..

Blaze Consulting provides extensive experience to support Decision Management technologies and systems for companies who need to automate and improve their operational business decisions. Their services include training, license delivery, and professional services. Blaze Consulting, well established in the Japanese market with many financial services clients, is expanding into manufacturing, healthcare, government, and telecom.

Learn more about Blaze Consulting Japan at www.blazeconsulting.co.jp.

About Sparkling Logic

Sparkling Logic Inc. is a California-based company leading technology innovation in Decision Management. Its SMARTS™ decision management system empowers business experts and business analysts in organizations that need to automate and improve business decisions. SMARTS uniquely leverages data in the decision management environment to facilitate the capture of business rules in the context of use cases, asses the impact of changes in the decision strategy, and combine decision logic revealed in historical data with business rules based on business policy and expertise.

Learn more about Sparkling Logic at www.sparklinglogic.com.

Sparkling Logic, Sparkling Logic SMARTS, RedPen and BluePen are trademarks of Sparkling Logic, Inc. in the United States and in other countries. Patents Pending.


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