HCF gets a helping hand from predictive analytics

31.05.2006
Australian private health insurer HCF has implemented a predictive analytics suite to help weed out fraudulent claims, target individual members and streamline the monotonous labor of data analysis.

HCF rolled out SPSS's Clementine in the middle of last year to cover four core components of its business operations: the identification of inappropriate practices, marketing, member behavior and member retention.

"We looked at a number of companies that specialized in predictive analytics before going with SPSS," HCF general manager of information management, Patrick Shearman said.

"We even looked at outsourcing to companies that do nothing but analytics, but chose SPSS because during our pilot stages, it worked excellently in-house."

The success of an in-house system was of vital importance for HCF, as the company deals with highly sensitive information when handling claims, Shearman said.

The SPSS system was integrated with HCF's existing claims processing software and infrastructure to allow real-time risk assessment from the backend and to help identify potentially fraudulent claims.