Risk, Fraud and Compliance
Improve Risk, Fraud and Compliance with Intelligent Processes
The challenge: When it comes to risk, fraud and compliance, insurers face complex conditions and requirements. More regulatory scrutiny and the high costs of increased risk and fraudulent behavior demand new ways to achieve tighter internal controls while improving operational efficiency.
Pega's insurance policy management software offers proven solutions that can help insurance carriers significantly enhance internal controls. By combining rule-based risk management with unified policies and procedures that can be dynamically applied to meet specific conditions, Pega makes it possible to capture your risk, fraud and compliance best practices as intelligent processes. The result is a comprehensive approach that helps you successfully mitigate business threats, manage fraud and meet stringent reporting requirements.
Key Capabilities
- Gain end-to-end risk management, compliance and policy enforcement. Deploy fully automated processes that automatically apply the right rules by product, geography, risk type and regulatory requirement for complete auditability and enforcement.
- Proactively manage risk throughout the case lifecycle. Gain a complete view of the risk represented by the customer – not just the policy – with Pega’s global KYC management platform.
- Improve fraud detection. Efficiently manage fraud and suspicious activity with Pega’s Financial Crimes Case Management with SmartTriage® functionality. Use rules-based triage and comprehensive case management to manage disparate monitoring systems by automatically identifying relationships between risk types, alerts and cases.
- Increase compliance at lower cost. Simplify and reduce the audit and compliance effort with real-time audit trails and a self-documenting solution that captures all decisions, process, steps, users, approval ranges, etc at the push of the button. Flexible reporting that provide operational dashboards, historical trend analysis and regulatory capabilities.
Pegasystems — Delivering Real-World Results
- Through real-time tracking, Nationwide automated their supplemental regulatory reporting cycle and has achieved an on-time, 99.3 percent accuracy record.
- UK-based Cardif Pinnacle, faced with a regulatory change that could have ended their creditor insurance business, used a Pega solution to open a new business unit and generate a new source of revenue.
