Turkey Insurance Fraud Bureau - Salih TAŞYON (2017)

Turkey Insurance Fraud Bureau
Salih Taşyon
5 October, 2017
©2017 SİSEB, All rightsreserved.

Agenda
o Insurance Information and Monitoring Center
o Product & Services
o Dashboard
o Insurance Fraud Bureau, Turkey
o Projects
o Organized Fraud
o Education & Awareness
o SİSBİS Black List

Insurance Information
and Monitoring Center

Public
Regulatory
and
Supervisory
Authority
Public
Institutions
Network Services
Our Network Services
This study provide to data agreement between Insurance Companies and the Center
Insurance
Association
of Turkey
Insurance
Companies
Treasury

Insurance
Companies
Policy
Number
Claim
File
Annual
Transaction
68 504
Mio
71
Mio
40
B
SBM with Numbers
31 K
Agency&Bank
81 K
Registered User

Transparency
Timely
information
Good
Communication
Accessibility
Long-range Plan
Continuous
Service
Physical security,
data security,
authorize,
application security
Information
Security
Corrected and
Quick Data Service
to Users
Correct
Data
Best Reported
Data to Use
Correct
Report
Enrich to the
Sector with
application and
services
Enrich to the
Sector
Main Principles

Product and
Services

All Main Branches in SBM
Fire
Motor Vehicles
Third Party Liability
Compulsory
Medical Malpractice
MoD
Compulsory Third
Party Liability for
Private Security
Marine Hull and
Machinery
Professional Liability
Third Party Liability
Insurance for Road
Passengers
Personal Accident
Health / Travel
ONLINE
ONLINE
ONLINE
Life Insurance Green Card
ONLINE
Compulsory
Personal Accident
for Mine Employees
Compulsory
Personal Accident
for Bus Passengers
Compulsory Product
Liability for LPG
Motor Vehicles
Compulsory Third
Party Liability
Compulsory Third
Party Liability for
Dangerous Materiel
and Hazardous Waste
ONLINE ONLINE
ONLINE ONLINE
ONLINE

Loss Adjuster Report
Accident Report
Assigning an AdjusterHeavy Damage
Traffic Offer Application
112 Emergency Accident Form
Produce and Damage Process

SBM Online Application
81.000 Registered
User
3.200 Screen
520.000 View/Daily

Traffic Offer Screen Application
www.sbm.org.tr
Presentingallcompaniestraffic
offerstogether
Dailyaveragerequest75K

Traffic PolicyInquiry
Doctor ProfessionalIndemnity
Transportation andPassenger
PolicyInquiry
GreenCardPolicyInquiry
MoD PolicyInquiry
Health/Life PolicyInquiry
Personal Insurance Policy Inquiry
Hazardous Materiel and LPG
ProfessionalIndemnityPolicyInquiry
Repair-ShopAssessment
E-Government Integration

easy
Sectoralanalysis
fastinstant
everywhere
for2years
Dashboard
https://kokpit.sbm.org.tr/qlikview/FormLogin.htm

Dashboard - Cockpit
Policy Count
Policy Count
Policy Count
Policy Count
Policy Count
Policy CountInforce
Policy CountInforce
Policy CountInforce
Policy CountInforce
Policy CountInforce
Paid Claim Amount (Tho.TL)
Claim File Count
Claim File Count
Net Premium (Tho.TL)

Dashboard - Cockpit
Policy Count
Policy Count
Policy Count
Policy Count
Policy Count
Policy CountInforce
Policy CountInforce
Policy CountInforce
Policy CountInforce
Policy CountInforce
Claim File Count
Claim File Count
January MayMarch July September November

17
Dashboard-KTT
January
February
March
April
May
June
July
August
September
October
November
December

18
Dashboard-KTT
January
February
March
April
May
June
July
August
September
October
November
December

19
Dashboard-KTT
January
February
March
April
May
June
July
August
September
October
November
December

20
Dashboard-KTT
January
February
March
April
May
June
July
August
September
October
November
December

21
Dashboard-KTT
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
September
October
November
December
Sunday
January
February
March
April
May
June
July
August

7 ₺
1.8 €
for 2 years
SMS Service Changed Parts Information of Vehicle

TAKE
PHOTO
LOCATION
CODE
READ
QR CODE
TELL
ACCIDENT
CRASH
POINT
SIGN and
SEND
USAGEAREA
37
traffic accident21,7 million
vehicles
25 milliondrivers
35 millionsmart phone
In Turkiye
per
seconds
REAL TIME TRACKING
ON THE MAP
Mobile Accident Report

286.087
download
386.322
download
672.409
Total
download
Internationally Awarded Application
MKT 2015
eTR Awarded
Best Mobile Application
Global Business Excellence
Most Innovative
Application
Protect to Nature
2.25 Tree
Daily
825 Tree
Annual
Mobile Accident Report Application

APPLE STORE & GOOGLE PLAY
Advanced Profile
IntensityMapathome
VideoRecordingofAccidentArea
Knowledgeoftheclosedrepair-shops,hospitals,agencies
Easierdrawinganaccident
Sharingtheotherprofile
Mobile Accident Report Application

All Public Insurance Inquiries on SBMOBIL
76,565
download
47,850
download 124,415 total
download
Traffic Offer Screen Published!
Monthly Average
*102,214
Inquiry
* According the last 4 months
Most Inquired Services (2016)
Traffic and MoD
TrafficPremium
Loss Adjuster Report
SBMobile Application

Insurance Fraud
Bureau,
Turkey

Organization
InvestigationDevelopment
Insurance Fraud Bureau
established 2015,September
in Insurance Information and
Monitoring Center

Reducing financial loss
Effective cooperation
Coordination
Periodic Report
Public Awareness «Fraud is a crime»
Mission

• Investigator Data Integration
• Analysis Screens
• Fraud Score (Personal, Repair-Shop)
• Indictments
• Legal Opinion
• Cooperation with police
• Terror Attack Damages
• TSEV
• Web Page
StrategicalTargets
• Data Collection
• PublicAwareness
• Meetings with companies
• DataAnalysis
• New Screen
• Online follow-up with Dashboard
• Meetings with all companies
(Life, non-life)
Visions
Projects
Organized Fraud
Education-
Awareness
SİSBİS
(Black-List)• Motor
• Non-Motor
• Social Media

Projects

Fraud Analytic Model
Claims
Address
Vehicles
Policy
Accident Reports
Insured and
Driver
Repair Shop
Adjuster
Agents
Analitical
Models
Social
Network
Analysis
1 Claims Score
2 Network Score
3 SNA
Business
Rules
Repair-Shop
Scoring
Daily and Weekly Jobs
Investigate relational links
Fraud Scoring
by Personal

Fraud Dashboard- SBM Detection
March June September DecemberJanuary

Fraud Dashboard- Company Detection
SBM Det. Comp. Det.
March June September DecemberJanuary

Scoring of the SocialMedia
Relationship between
fraudulent
Detection the networkof
people involved in the
accident
36
Social Media Analytics

Investigator Data Integration
 Collecting data
37
 Fraud analytics  Predictive models

Repair-Shop Scoring
Calculation of Repair-Shop fraud score
Prevention of fraud by Repair-Shop
Investigation of the claim file which has a
Repair-Shop with high fraud score
Pre-information about the claim file related
with Repair-Shop
38
©2016 SİSEB, Tüm hakları saklıdır.

HEALTH
BODILY
INJURED
©2017 SİSEB, Tüm haklarısaklıdır.
LIFE – PERSONAL
ACCIDENT FIRE
E&Y
InsuranceAssociation
of Turkey-
Committees
Health Insurance Committee
June 2017 – September 2017
of Turkey-
Committees
Non-Life Claims Committee
Anti-Fraud Committee
June 2017 – September 2017
ofTurkey-Committees
Casualty Insurance
Committee Life Insurance
Committee
October 2017
of Turkey-
Committees
Fire Insurance Committee
October 2017
Non Motor Branches

Organized Fraud

Organized
Fraud
Prosecution EGM Prosecution
not opened
In
Investigation
New FNOL
Not
Organized
Fraud
Total
Case
Numbers 8 6 2 1 2 2 21
Case
Amount
(mio TL)
6,08 3,57 10,6 0 0 0,3 20,55
Organized Fraud

Education &
Awareness

SİSBİS
Black List

SİSBİS (Black-List)
Report
Notice withid
number and
plate
Single screen design
Passive notice possibility
SİSEB messagescreen
Difference between
suspicious
and proof
Fraud Web Menu
Improve report
screens Video
Loss Adjuster
Agency
Citizen
Non-Life Insurance
Companies
Life and Pension Companies

Total
21.540
* By 10.2017
Total
21.540
SİSBİS (Black-List) Report
1.408 1.490
Suspicious Cases
4.188
3.780
3.092
2.594 2.699
2.289
2010 2011 2012 2013 2014 2015 2016 2017*
2.593
4.076 4.479 Total
3.041
2.268 33.653
2010 2011 2012 2013 2014 2015 2016 2017*
Suspicious People
6.525
5.080 5.591
20.772
203 154 141 133 85 52
Suspicious Cases By Branches

48
Dashboard – SİSBİS (Black List)
Reported –by
All Sources
Reported –by
Companies
Reported –by
Citizens
Reported –by
OtherSources
Year Month

Ongoing Important
Projects

• To increase of drive quality in
Turkey by feedback & reward
them
• Toreduce of total damage by to
increase of drive quality and to
decrease of accident frequency
• Faster reach to accident area and
to decrease injuries and deaths
by automatic accident
notification
• Toincrease the public security by
Vehicles Following System
• Traffic and navigation services
• Ecosystem services
• Toreduce the accident frequency
by to increase of drive quality
and the awareness
• Toreduce damage, body injuries
and the cost of spare part
Object Internet has transformed to Services by Telematics Project
Drive Quality
ToDecrease of Injuries and
Financial Loss
The Other Benefits
Contribution to Economy
Reduce Accident Frequency
Public
Benefits
Telematics Project
Ongoing… ©2017 SİSEB, All rightsreserved.

Cooperation with EGM (Turkish National Police) and KGM
(General Directorate of Highways) !
TARGET
• Accident intensity map
• Determine to blind point and improvement area, Integration of accident
intensity map with weather etc.
Accident Location (Geocode) Information

• Learning UAVT code with full address
• Learning full address with UAVT
• Importing an address in UAVT format in fire policies
• Importing an address in UAVT format in all
City
District
Street
Avenue
Flat Number
Apartment
Number
Building UAVT
Independent
UAVT
• Policy Follow up
• Damage Follow up
• Profit
• Prevention Fraud
AchievementScheduled Actions
UAVT(National Address Database) Transition

 Financial score notification to insurance
companies via
 All costumer credit information
 Financial competency
 Financial moral analysis
Banking Association Risk Center
Financial Score & Fraud Assessment

Turkey Insurance Fraud Bureau - Salih TAŞYON (2017)

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