Tawuniya combats insurance fraud with AI solutions powered by SAS  

As part of the partnership, SAS will offer an end-to-end Insurance Fraud Management system for Tawuniya's health insurance Line of Business in efforts to improve the speed of claims settlement and fraud identification

Abdulaziz Hassan Al-Boug, CEO of Tawuniya

Abdulaziz Hassan Al-Boug, CEO of Tawuniya

Riyadh, Saudi Arabia: SAS, The Leader in Analytics, has announced a recent partnership with Company for Cooperative Insurance (Tawuniya), the poineering insurance company in Saudi Arabia, to bolster their Analytics and fraud/waste prevention capability within its medical insurance segment.  

As part of the partnership, SAS will offer an end-to-end Insurance Fraud Management system for Tawuniya’s health insurance Line of Business in efforts to improve the speed of claims settlement and fraud identification. Through the use of cutting-edge analytics, Tawuniya will be able to leverage SAS predictive modeling to detect anomalies and outliers to minimize losses. With growing concerns of frauds, scams, and schemes caused by con-artists trying to take advantage of the disruption brought by the COVID-19 pandemic. Even pre-pandemic, the challenge proved difficult worldwide, according to Global Health Care Anti-Fraud Network, it is estimated that $260 billion, approximately 6 percent of global health care spending is lost to fraud annually. This strategy is aligned with the insightful Saudi Vision 2030 and will enable customers to benefit from a more efficient medical claim cycle, powered by the SAS AI, Analytics and Machine Learning (ML) capabilities embedded in the solution.

Commenting on the partnership, Abdulaziz Hassan Al-Boug, CEO of Tawuniya, stated, “Tawuniya has good experience in combating fraud operations, and applied its system with several indicators to detect fraud and reduce losses resulting from fraudulent claims. By working with SAS, we want to improve our experience and take advantage of  fraud detection technology to control costs and manage medical claims. The incorporation of AI tools within our claims-handling process is essential to help ensure the accuracy and expedition of our claims settlement, which will certainly strenghthen our customers’ trust and improve their satisfaction. Utilizing AI and Analytics has taken center stage across our operations, the transformation is incorporated across all areas of our operations. This project is a key initiative within our Digital Transformation program, which will increase efficiency, speed, and reliability across the organization, improving our services for the clients as well as the employees”. 

“All types of insurance organizations are vulnerable to insurance fraud especially considering the digital and distanced processes due to the ongoing pandemic. The medical sector, especially,  has recently been rapidly targeted. To identify fraudulent activities and expedite internal processes leveraging AI and Analytics solutions are  therefore becoming critical. Our industry leading  Detection and Investigation for Insurance solution  will assist Tawuniya to predict behavior patterns, safeguard customers, and efficiently manage risk to help guarantee and bolster customers’ trust and experience at all touchpoints. Through this strategic partnership with Tawuniya, we aim to accelerate KSA’s digital transformation agenda and capitalize on the momentum to boost the country’s productivity and fast-track its digital-first journey with SAS’ analytics capabilities,” said Zafir Junaid. General Manager – North Gulf at SAS. 

SAS Detection and Investigation for Insurance is an end-to-end analytical and data management solution that allows health insurers such as Tawuniya to probe into fraud, waste and abuse from all medical service providers as well as the opportunity to support real-time response to individual claims. For the insurer, it helps identify fraud and error patterns that are difficult to see in the sea of health insurance claims data and helps optimize the efficiency of the insurers investigators, in both reducing false-positives and provide clear ‘analytical evidence’ for the investigator. For the policyholder, the ultimate benefits will be a reduction in premiums and an overall speedier claims handling process.


About SAS

SAS is the leader in analytics. Through innovative software and services, SAS empowers and inspires customers around the world to transform data into intelligence. SAS gives you THE POWER TO KNOW®

SAS and all other SAS Institute Inc. product or service names are registered trademarks or trademarks of SAS Institute Inc. in the USA and other countries. ® indicates USA registration. Other brand and product names are trademarks of their respective companies. Copyright © 2020 SAS Institute Inc. All rights reserved.

Send us your press releases to pressrelease.zawya@refinitiv.com

© Press Release 2020

Disclaimer: The contents of this press release was provided from an external third party provider. This website is not responsible for, and does not control, such external content. This content is provided on an “as is” and “as available” basis and has not been edited in any way. Neither this website nor our affiliates guarantee the accuracy of or endorse the views or opinions expressed in this press release.

The press release is provided for informational purposes only. The content does not provide tax, legal or investment advice or opinion regarding the suitability, value or profitability of any particular security, portfolio or investment strategy. Neither this website nor our affiliates shall be liable for any errors or inaccuracies in the content, or for any actions taken by you in reliance thereon. You expressly agree that your use of the information within this article is at your sole risk.

To the fullest extent permitted by applicable law, this website, its parent company, its subsidiaries, its affiliates and the respective shareholders, directors, officers, employees, agents, advertisers, content providers and licensors will not be liable (jointly or severally) to you for any direct, indirect, consequential, special, incidental, punitive or exemplary damages, including without limitation, lost profits, lost savings and lost revenues, whether in negligence, tort, contract or any other theory of liability, even if the parties have been advised of the possibility or could have foreseen any such damages.

More From Press Releases