Winner of the 2024 Model Insurer Award for Data, Analytics and AI
Abstract
For long-term care (LTC) insurance, combating fraud has become an imperative pursuit, prompting a significant focus on innovation. The multifaceted nature of long-term care insurance fraud poses a formidable challenge, necessitating proactive and dynamic solutions to safeguard the integrity of the system. Innovation in this domain is crucial for several key reasons. In this report we will dive into John Hancock’s approach to LTC fraud identificaton and prevention and the innovative steps they took to optimize and accelerate fraud investigations.
Key Factors for Success
1.Having a high performing team – This project gave John Hancock an opportunity to challenge their team’s top talent. In addition, the selection of a highly capable, culturally aligned consultant accelerated the work.
2.Collaboration – Getting it done together, this was a highly collaborative team effort requiring multiple functions to come together around a single goal.
3.Think Big – Standing up new technology on the scale of the Knowledge Graph meant having an ambitious target that would benefit multiple stakeholders. The team pushed themselves to imagine the possibilities so that they could set a vision and a plan to achieve it from the start of the initiative.