Agent mediated provision of insurance services: two case studies: fraud and repairs

  • Authors:
  • Chris van Aart;Valentina Tamma

  • Affiliations:
  • Sogeti Nederland B.V., GJ Rotterdam, The Netherlands;University of Liverpool, United Kingdom

  • Venue:
  • Proceedings of the 10th international conference on Electronic commerce
  • Year:
  • 2008

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Abstract

In this work we present two business templates able to decrease risk and decrease costs in the insurance market realizing a successful claim management process capable of going across company boundaries. Risks can be decreased by having fraud detection agents gather evidence for (possible) fraud chains, using ontologies that model knowledge about the various types of frauds, and the mappings between different back-offices of involved parties. Costs can be decreased by having agents dealing with the administrative process of claim handling, saving time and personnel costs. Another advantage is that these agents form an agent mediated marketplace where prices and quality for car repair are determined by market mechanisms, instead of long-term contracts. The fraud detection and car repair business templates are implemented in an InsuranceGrid combining grid, ontology and agent technology. Because of the need for autonomy and the complexity of decision making process underlying fraud detection, the InsuranceGrid was implemented as a multi-agent system. By using ontologies, the knowledge about the insurance domain and processes is explicitly represented, making the obtained model transparent, standardised and maintainable. Business decision makers from insurance companies recognize the business template with their opportunities to delegate claims handling tasks to business agents.