Social networking involves building
relationships or sharing information via
online social media apps like Facebook,
Twitter or LinkedIn. Conversely, SNA is
an analytical approach used to establish
important relationships and links among
people, places and things which might be
unknown to insurance personnel at the
time of claim.
The role of SNA in claims
For insurance carriers, the differentia-
tion between SNA and social media is an
important distinction. Claim’s adjusters
and investigators often examine a claim-
ant’s social media activity for inconsis-
tencies and misrepresentations while
validating claims documentation. That’s
proven to be a valuable part of the inves-
On the other hand, the social networks uncovered when analyzing insurance claims data are characterized by the
people, places and things in an insurance
transaction and the interconnectivity between them.
In claims fraud detection, SNA is both
Increased view of
an analytical and visual tool that helps
discover, analyze, and visualize social
networks and expose dishonest actors
who are exploiting insurer vulnerabilities.
SNA uncovers such things as shared
home addresses, business addresses, bank
accounts, home telephone numbers, cell
phone numbers, automobiles, medical
providers, lawyers, repair shops, policy
numbers, payments and claims. Having
this information readily connects individuals who were otherwise not known to
have a business or personal relationship,
which is often indicative of fraud.
Absent an effective SNA tool, the links
between individuals and entities likely
goes undetected given the voluminous
amounts of application, policy and claims
data routinely collected and processed by
insurance companies today.
Paying claims efficiently
While the existence of a social network
might initially seem suspicious and indic-
ative of fraud, further investigation may
determine that the apparent connectivity
between certain individuals and entities
is innocuous and easily explained.
That’s one of the profitable returns of
effective SNA. It helps build a complete
real-world, real-time picture of claims
activity and slashes claims fraud without
hurting genuine customers.
Because regulatory requirements dic-
tate claims processing service level agree-
ments (SLAs), time is at a premium and
the priorities are to pay legitimate claims
faster. SNA snapshots streamline the in-
vestigative process and reduce money
spent on bad claims, while providing a
clear picture of social networks.
Avoiding “pay and chase” is imperative. The added network view helps adjudicate legitimate claims quickly and
intuitively, while referring suspicious or
potentially fraudulent claims for further
Using Social Network Analysis
to Find Fraud in Your Data
The term Social Network Analysis (SNA) is often errantly associated with the type of social networking accomplished via social media.