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Why graph technology
makes sense for fraud
detection and customer 360
projects in Insurance
March 2023
Introduction
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
► 13+ years of experience in data science diversely spread across consulting,
industry, and start-up
► 3+ years in graph technology building data products
► Currently leading the tech for wavespace AI Labs and Data Science for Utilities at
EY Ireland
► A data scientists & a professional accountant who bridges the gap between
technology and business value
► Active contribution to Data Science community and a vocal supporter of DE&I in
Data Science
Inability to
recommend Next
Best Action (NBA)
Non-optimized fraud
identification and
actioning capabilities
Lack of full view of
customers and
agents
Insurers today are struggling with identity resolution which
impacts growth
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
►Silo-ed legacy systems
►Obsolescence of EDW
►Fast changing customer needs
►Primarily broker-mediated market
►Recent fraud trends - Deepfakes
►Increased manual processing
►Reporting than recommending
►Reactive rule-based policies
►Operations at scale
Caused by
Many companies today utilize Customer Graphs:
To support the demands of the digital
business, enterprise architects must
consider how best to link large volumes
of complex, siloed data... Graph
databases are a powerful
optimized technology that link
billions of pieces of connected data to
help create new sources of value
for customers and increase
operational agility for customer
service.
– Forrester
Zurich
Large online
shopping site
These challenges have been successfully solved using graph
databases
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
Customer 360° View in an Insurance Company
UNIFIED VIEW
OF THE CUSTOMER
Market-
ing
Sales Policy
Claims
Contact
Centre
Broker
External
Data
Demogra
phics
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
A unified Customer 360° view enables:
• Data-driven, customer-centric
experiences
• Efficient and automated sales &
marketing
• Improved compliance and better
underwriting through fraud detection
• Consistent view of operational metrics
across business segments
• Improved decision-making based on
more reliable reporting
Why graph database is better than SQL
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
Graph can add value in any environment where:
Data is interconnected and
relationships matter
Data needs to be read and queried
with optimal performance
Data is evolving and data model is
not always fixed and pre-defined
Before
Name Address Policy Claims Broker
Phone
Customer Golden Record
LOB - System 1
LOB - System 2
LOB - System 3
Agent Quote
Source Systems EDW Schema Slow Execution
Why graph database is better than SQL
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
Graph can add value in any environment where:
Data is interconnected and
relationships matter
Data needs to be read and queried
with optimal performance
Data is evolving and data model is
not always fixed and pre-defined
After
LOB - System 1
LOB - System 2
LOB - System 3
Agent Quote
Source Systems Graph Schema Faster execution
Customer Golden Profile
Customer Golden Profile will create cross-LOB data assets to help
answer key strategic questions
Integrating data into the graph and building analytics and BI-layers on top to enable rapid extraction of cross-LOB
features on a customer for context-based decision making
Rapidly test and operationalize
new analytical capabilities
• Who are our
customers?
• What drives a
customer to make
a buy decision?
• How to
understand
different customer
behaviours?
• How to get right
and up-to-date
information about
every customer?
• How to create
effective risk
policies?
We want to
understand…
Identify & ingest
multiple data sources
All data is
aggregated and
linked together in
the graph that
provides an entity
centric view of all
customers,
products, and
merchants
Link and maintain
graph database
Create new data
assets and signals
Key components of the Customer Golden Profile
Customer
Agent
Product
Master Data
Quote
Policy
Claims
Customer Journey Data
Risk & Compliance
Insured Asset
Third-party
External Data
Build a complete view
of customers’
relationship with
businesses
Identify key data
elements and customer
behaviors within and
across Lines of
Business
Develop customer 360
level attributes that are
predictive of customer
behaviour
Example Capabilities
• Predict Churn
• Personalise product
bundling
• Optimise discount via
agent effectiveness
• Predict conversion in
sales cycles
• Predict effectiveness of
cross-sell & up-sell
schemes
• Predicting fraud triangles
• Effective Chatbot for
Contact Centre activities
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
How Graphs add value to the insurance business
Increase Cross-
Sell and Upsell
Increase
Retention
Increase Customer
Satisfaction
Reduce Cost to
Acquire and
Service
Reduce Fraud
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
And how to measure them?
Value(€) and
Volume(#) of
policies sold to
existing customers
in a year
Measure what matters . . .
Annual customer
churn rate across
and within LOB
Average of CSAT
score and Annual
NPS score
Average time-to-
resolve at Contact
Centre
Direct and Indirect
expenses by
Customer Journey
milestones
Loss ratio and
combined ratio
Straight-Through-
Processing
policies
Sales / Marketing
• Customers are not always “price sensitive” but
“value sensitive”
• Referral programs are effective along with product
bundling
• Agent is the “influencer” but customers always
validate the information online
• Discount optimisation based on “influence
capability” of the agents
Risk & Compliance
• Increased risk exposure due to “serial”
entrepreneurs (a.k.a habitual offenders)
• Common elements between claims - like garage,
doctor, 3rd party in car & liability insurance, etc.
• Loss of opportunities from traditional rule-based risk
policies – E.g., a young driver is not always the
riskiest driver
Some of the interesting insights were
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
Team:
• Data Product Owner
• Graph Architect
• Data Engineer
• Full-stack Developer
• Data Scientist
• Report Developer
Problem / Scope
What will the graph
solve?
Production Build
Cloud Pilot
Localhost POC
Graphy Problem
Business need, Data sources Data modeling, API, example queries Data snapshot, reference architecture, API
suite
Hardening, scheduled & stream ETL, Live
UX
Stakeholder Input
Graph Design
Data Work
APIs / Data Services
Integration
Scale
Validate
What questions can
now be answered?
Connect
Does the data support
the graph model and
semantics?
Mobilize
What data does the
new experience need?
Use Cases
What is the feedback
from the business on
how well the graph
solves the use case?
Deploy
What monitoring,
testing, process needs
to be put in place to
achieve a robust SLA?
Asking better questions
Start small and scale
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
Making Graphs work is not a sprint but a marathon
o Once the data integration phase is complete, the environment is ready for iterating through several 3-4 week Use Case sprints.
o At the end of each sprint, an assessment of the results, in terms of revenue and cost benefits, will guide the decision for additional Use
Cases.
o In parallel to each sprint,
o Inform the senior stakeholders on current decision processes to develop more Use Cases for the backlog
o Identify “evangelist” business users for early adoption and acting as voice of influence amongst end-users
Continuous Use Case Development – Sustain and Scale
User
Interview
Sprint Backlog and
Scheduling
Business
Use Case
Business
Use Case
Business
Use Case
Business
Use Case
Model
Development
Industrialisation
BAU Operations
Strategic
Reporting
Self-service
reporting
Code
Config
BI / MI
Monitoring Controls Automation
One-off outputs
that cannot be
sustained are
retired after use
Outputs
decommissioned if
not deemed feasible
Delivery Pod
Delivery Pod
Delivery Pod
Successful use cases, Pod
move into build
Experiment failed, Pod spun
down
Delivery Pod
Delivery Pod
Pod creates a single use model
Pod output planned for BAU run
Model
libraries
Maintenance
Sprint Case 1
Sprint Case 2
Sprint Case 3
Sprint Case 4
Sprint Case 5
Sprint Case 6
…
-- W1
-- W4
-- W7
-- W10
-- W13
-- W16
-- …
Allocation
to
Delivery
Pods
Key learnings
Envision end
product at data
modelling phase
Fail Fast. Learn
Faster. (Agile)
Shipping beats
perfection (Product)
Dependency on IT
Infrastructure &
Security
Do not
underestimate Data
Quality
Improvement
Early business
adopters becomes
product evangelist
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
Plasma Donor
360
Retail
Customer
360
Customer
Identity
Enterprise
Org
Design
FinServ
Know Your
Customer
Regulatory
Reporting
Data Lineage
Anti-Money
Laundering
GCN
Cruiseline
Activity
NBA
Batch
Geneaology
B2B Event
NBA
Capital
Projects Cost
Visibility
COVID-19 Risk
Tracking
Fuels Tradiing
Forecasting
Global
Compliance
Monitoring
Active
Directory
Access
Controls
Financial
Ledger
Transaction
Lineage
FINANCIAL
SERVICES
SALES &
MARKETING
ENERGY
ASSET
MANAGEMENT
LIFE
SCIENCES
RISK
EY has a large and growing graph practice,
with over 200 consultants globally.
We see a wide range of graph use cases
across all sectors and have delivered several
compelling graph solutions to help our clients
drive greater insight, efficiency and value.
EY and Graph Technology
Why graph technology makes sense for fraud detection and customer 360 projects in insurance
EY SOLUTIONS
EY | Building a better working world
EY exists to build a better working world, helping to
helping to create long-term value for clients, people and
people and society and build trust in the capital markets.
EY refers to the global organisation, and may refer to one or more, of the member firms
of Ernst & Young Global Limited, each of which is a separate legal entity. Ernst &
Young Global Limited, a UK company limited by guarantee, does not provide services
to clients. Information about how EY collects and uses personal data and a description
of the rights individuals have under data protection legislation are available via
ey.com/privacy. EY member firms do not practice law where prohibited by local laws.
For more information about our organisation, please visit ey.com.
© 2023 Ernst & Young. All Rights Reserved.
The Irish firm Ernst & Young is a member practice of Ernst & Young Global Limited. It
is authorised by the Institute of Chartered Accountants in Ireland to carry on investment
business in the Republic of Ireland.
Ernst & Young, Harcourt Centre, Harcourt Street, Dublin 2, Ireland.
Information in this publication is intended to provide only a general outline of the
subjects covered. It should neither be regarded as comprehensive nor sufficient for
making decisions, nor should it be used in place of professional advice. Ernst & Young
accepts no responsibility for any loss arising from any action taken or not taken by
anyone using this material.
ey.com

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EY + Neo4j: Why graph technology makes sense for fraud detection and customer 360 projects

  • 1. Why graph technology makes sense for fraud detection and customer 360 projects in Insurance March 2023
  • 2. Introduction Why graph technology makes sense for fraud detection and customer 360 projects in insurance ► 13+ years of experience in data science diversely spread across consulting, industry, and start-up ► 3+ years in graph technology building data products ► Currently leading the tech for wavespace AI Labs and Data Science for Utilities at EY Ireland ► A data scientists & a professional accountant who bridges the gap between technology and business value ► Active contribution to Data Science community and a vocal supporter of DE&I in Data Science
  • 3. Inability to recommend Next Best Action (NBA) Non-optimized fraud identification and actioning capabilities Lack of full view of customers and agents Insurers today are struggling with identity resolution which impacts growth Why graph technology makes sense for fraud detection and customer 360 projects in insurance ►Silo-ed legacy systems ►Obsolescence of EDW ►Fast changing customer needs ►Primarily broker-mediated market ►Recent fraud trends - Deepfakes ►Increased manual processing ►Reporting than recommending ►Reactive rule-based policies ►Operations at scale Caused by
  • 4. Many companies today utilize Customer Graphs: To support the demands of the digital business, enterprise architects must consider how best to link large volumes of complex, siloed data... Graph databases are a powerful optimized technology that link billions of pieces of connected data to help create new sources of value for customers and increase operational agility for customer service. – Forrester Zurich Large online shopping site These challenges have been successfully solved using graph databases Why graph technology makes sense for fraud detection and customer 360 projects in insurance
  • 5. Customer 360° View in an Insurance Company UNIFIED VIEW OF THE CUSTOMER Market- ing Sales Policy Claims Contact Centre Broker External Data Demogra phics Why graph technology makes sense for fraud detection and customer 360 projects in insurance A unified Customer 360° view enables: • Data-driven, customer-centric experiences • Efficient and automated sales & marketing • Improved compliance and better underwriting through fraud detection • Consistent view of operational metrics across business segments • Improved decision-making based on more reliable reporting
  • 6. Why graph database is better than SQL Why graph technology makes sense for fraud detection and customer 360 projects in insurance Graph can add value in any environment where: Data is interconnected and relationships matter Data needs to be read and queried with optimal performance Data is evolving and data model is not always fixed and pre-defined Before Name Address Policy Claims Broker Phone Customer Golden Record LOB - System 1 LOB - System 2 LOB - System 3 Agent Quote Source Systems EDW Schema Slow Execution
  • 7. Why graph database is better than SQL Why graph technology makes sense for fraud detection and customer 360 projects in insurance Graph can add value in any environment where: Data is interconnected and relationships matter Data needs to be read and queried with optimal performance Data is evolving and data model is not always fixed and pre-defined After LOB - System 1 LOB - System 2 LOB - System 3 Agent Quote Source Systems Graph Schema Faster execution Customer Golden Profile
  • 8. Customer Golden Profile will create cross-LOB data assets to help answer key strategic questions Integrating data into the graph and building analytics and BI-layers on top to enable rapid extraction of cross-LOB features on a customer for context-based decision making Rapidly test and operationalize new analytical capabilities • Who are our customers? • What drives a customer to make a buy decision? • How to understand different customer behaviours? • How to get right and up-to-date information about every customer? • How to create effective risk policies? We want to understand… Identify & ingest multiple data sources All data is aggregated and linked together in the graph that provides an entity centric view of all customers, products, and merchants Link and maintain graph database Create new data assets and signals Key components of the Customer Golden Profile Customer Agent Product Master Data Quote Policy Claims Customer Journey Data Risk & Compliance Insured Asset Third-party External Data Build a complete view of customers’ relationship with businesses Identify key data elements and customer behaviors within and across Lines of Business Develop customer 360 level attributes that are predictive of customer behaviour Example Capabilities • Predict Churn • Personalise product bundling • Optimise discount via agent effectiveness • Predict conversion in sales cycles • Predict effectiveness of cross-sell & up-sell schemes • Predicting fraud triangles • Effective Chatbot for Contact Centre activities Why graph technology makes sense for fraud detection and customer 360 projects in insurance
  • 9. How Graphs add value to the insurance business Increase Cross- Sell and Upsell Increase Retention Increase Customer Satisfaction Reduce Cost to Acquire and Service Reduce Fraud Why graph technology makes sense for fraud detection and customer 360 projects in insurance And how to measure them? Value(€) and Volume(#) of policies sold to existing customers in a year Measure what matters . . . Annual customer churn rate across and within LOB Average of CSAT score and Annual NPS score Average time-to- resolve at Contact Centre Direct and Indirect expenses by Customer Journey milestones Loss ratio and combined ratio Straight-Through- Processing policies
  • 10. Sales / Marketing • Customers are not always “price sensitive” but “value sensitive” • Referral programs are effective along with product bundling • Agent is the “influencer” but customers always validate the information online • Discount optimisation based on “influence capability” of the agents Risk & Compliance • Increased risk exposure due to “serial” entrepreneurs (a.k.a habitual offenders) • Common elements between claims - like garage, doctor, 3rd party in car & liability insurance, etc. • Loss of opportunities from traditional rule-based risk policies – E.g., a young driver is not always the riskiest driver Some of the interesting insights were Why graph technology makes sense for fraud detection and customer 360 projects in insurance
  • 11. Team: • Data Product Owner • Graph Architect • Data Engineer • Full-stack Developer • Data Scientist • Report Developer Problem / Scope What will the graph solve? Production Build Cloud Pilot Localhost POC Graphy Problem Business need, Data sources Data modeling, API, example queries Data snapshot, reference architecture, API suite Hardening, scheduled & stream ETL, Live UX Stakeholder Input Graph Design Data Work APIs / Data Services Integration Scale Validate What questions can now be answered? Connect Does the data support the graph model and semantics? Mobilize What data does the new experience need? Use Cases What is the feedback from the business on how well the graph solves the use case? Deploy What monitoring, testing, process needs to be put in place to achieve a robust SLA? Asking better questions Start small and scale Why graph technology makes sense for fraud detection and customer 360 projects in insurance
  • 12. Making Graphs work is not a sprint but a marathon o Once the data integration phase is complete, the environment is ready for iterating through several 3-4 week Use Case sprints. o At the end of each sprint, an assessment of the results, in terms of revenue and cost benefits, will guide the decision for additional Use Cases. o In parallel to each sprint, o Inform the senior stakeholders on current decision processes to develop more Use Cases for the backlog o Identify “evangelist” business users for early adoption and acting as voice of influence amongst end-users Continuous Use Case Development – Sustain and Scale User Interview Sprint Backlog and Scheduling Business Use Case Business Use Case Business Use Case Business Use Case Model Development Industrialisation BAU Operations Strategic Reporting Self-service reporting Code Config BI / MI Monitoring Controls Automation One-off outputs that cannot be sustained are retired after use Outputs decommissioned if not deemed feasible Delivery Pod Delivery Pod Delivery Pod Successful use cases, Pod move into build Experiment failed, Pod spun down Delivery Pod Delivery Pod Pod creates a single use model Pod output planned for BAU run Model libraries Maintenance Sprint Case 1 Sprint Case 2 Sprint Case 3 Sprint Case 4 Sprint Case 5 Sprint Case 6 … -- W1 -- W4 -- W7 -- W10 -- W13 -- W16 -- … Allocation to Delivery Pods Key learnings Envision end product at data modelling phase Fail Fast. Learn Faster. (Agile) Shipping beats perfection (Product) Dependency on IT Infrastructure & Security Do not underestimate Data Quality Improvement Early business adopters becomes product evangelist Why graph technology makes sense for fraud detection and customer 360 projects in insurance
  • 13. Plasma Donor 360 Retail Customer 360 Customer Identity Enterprise Org Design FinServ Know Your Customer Regulatory Reporting Data Lineage Anti-Money Laundering GCN Cruiseline Activity NBA Batch Geneaology B2B Event NBA Capital Projects Cost Visibility COVID-19 Risk Tracking Fuels Tradiing Forecasting Global Compliance Monitoring Active Directory Access Controls Financial Ledger Transaction Lineage FINANCIAL SERVICES SALES & MARKETING ENERGY ASSET MANAGEMENT LIFE SCIENCES RISK EY has a large and growing graph practice, with over 200 consultants globally. We see a wide range of graph use cases across all sectors and have delivered several compelling graph solutions to help our clients drive greater insight, efficiency and value. EY and Graph Technology Why graph technology makes sense for fraud detection and customer 360 projects in insurance EY SOLUTIONS
  • 14. EY | Building a better working world EY exists to build a better working world, helping to helping to create long-term value for clients, people and people and society and build trust in the capital markets. EY refers to the global organisation, and may refer to one or more, of the member firms of Ernst & Young Global Limited, each of which is a separate legal entity. Ernst & Young Global Limited, a UK company limited by guarantee, does not provide services to clients. Information about how EY collects and uses personal data and a description of the rights individuals have under data protection legislation are available via ey.com/privacy. EY member firms do not practice law where prohibited by local laws. For more information about our organisation, please visit ey.com. © 2023 Ernst & Young. All Rights Reserved. The Irish firm Ernst & Young is a member practice of Ernst & Young Global Limited. It is authorised by the Institute of Chartered Accountants in Ireland to carry on investment business in the Republic of Ireland. Ernst & Young, Harcourt Centre, Harcourt Street, Dublin 2, Ireland. Information in this publication is intended to provide only a general outline of the subjects covered. It should neither be regarded as comprehensive nor sufficient for making decisions, nor should it be used in place of professional advice. Ernst & Young accepts no responsibility for any loss arising from any action taken or not taken by anyone using this material. ey.com

Editor's Notes

  1. Internal database Customer demographics (master) Quotations generated Policy Claims Payments data Broker Call centre interactions (enquiry, complaints, requests) Web portal interactions (online transactions – policy renewals, FNOL, claims, etc.) Social media interactions (enquiry, complaints, requests, feedback) External database Companies database (non-individual customers) Address database – entity resolution Point of interest – OSM GIS data Weather data Property registration, Marine vessels, Car registration data A unified view of the customer is foundational to a successful digital transformation. The customer 360° view is derived from customer, product, sales, marketing, support and web data. Data is ingested & cleaned in a data lake, unified & analyzed in a Knowledge Graph, and mobilized via API microservices.
  2. Using the same license plate, three different quotes were made with different names, addresses and birth dates. Therefore, the last quote was simply accepted