Risk, Fraud and Compliance

Improve Compliance and Mitigate Risk with Intelligent Processes

The Challenge: As companies around the world face more regulatory oversight, isolated systems and inefficient manual processes make compliance increasingly difficult. At the same time, companies face higher risk and mounting losses from sophisticated fraud schemes that outdated systems and manual processes cannot effectively detect or prevent.

Pega solutions are designed to help you successfully address the growing burden of regulation, better manage risk and reduce fraud losses. With Pegasystems, you can easily capture your company’s risk, fraud and compliance best practices and turn them into intelligent processes that can be applied consistently across the organization.

Flexible rules adjust processes automatically to account for specific geographic, product, channel or customer-related regulations and policies. Customer behavior can be dynamically monitored to detect possible fraud and immediately adjust the flow of a customer interaction. Payment, settlement and collections processes can be automated from end-to-end. And because Pegasystems empowers business owners to create and manage these processes, you can quickly adapt them to reflect ever-changing regulations, risk factors and business challenges.

• Increase policy enforcement across the enterprise. Leverage holistic, intent-driven processes that guide users and automate critical work steps with intelligent routing, escalation and prioritization so that privacy and compliance requirements are followed consistently and correctly.
• Improve risk management. Use predictive analytics to simulate what-if scenarios and understand the impact of strategies for mitigating risk.
• Increase compliance at lower cost. Simplify and streamline the process with Pega’s self-documenting solutions that maintain a complete audit trail along with all of the rules and processes that were applied to a task.

Pegasystems — Delivering Real-World Results

Companies in every industry section rely on Pega’s proven solutions to help them effectively manage risk, improve compliance and reduce fraud.

• Through real-time tracking, Nationwide Insurance automated their regulatory reporting cycle for an on-time, 98.5 percent error-free accuracy record.
• A leading healthcare information company faced complying with the new Medicare Part D law in 4 months. Using Pega solutions, the company successfully implemented a solution for taking applications in less than 10 weeks which provides full compliance with architectural standards and twice achieved three-year security accreditation and certification.
• A leading P&C insurer uses Pega technology to detect conditions that signal potential fraud and route the claim to a specialized adjuster as part of an overall solution to streamline claims reporting that has shortened processing time over 50 percent.