Demo Intro: Insurance Fraud

It’s critical for companies to have a total view of their customers and all their associated transactions. Gemini Explore provides a powerful way to visualize this data and analyze complex relationships and connections between customers and the data connected to them.

In this example, a mid-size multi-state health insurance company runs fraud detection algorithms and exposes a fraud ring run by doctors and an insurance salesman at one specific clinic. The graph in this case shows the relationships between patients, the injuries they reported, the clinic they went to, the doctor that saw them, and the person that sold them their insurance policy. 

But something looks a little off. There are two clusters of patients around two doctors. Who sold their insurance policies? If we view the overall graph, we see two main clusters of patients and the two doctors whose patients bought from one salesperson and all went through the same clinic.

With Gemini Explore for Customer 360, an analyst can see the full picture of a possible fraud ring, how to begin an investigation and begin a referral to legal authorities. Explore shows the seen and unseen connections in data sets showing clusters, outliers, and patterns to give businesses of all sizes invaluable insights to get answers faster, respond to unusual events, and take the next best action – all at a glance.

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