The California Department of Insurance is in the planning stages for a new system that will detect suspected cases of fraud using data analytics.
The Fraud Data Analytics Software (FDAS) is envisioned to use internal data and external data sources to assign a risk ranking to cases within the department's case management system.
The Department of Insurance is interested in a solution based on Software as a Service (SaaS) or Commercial Off the Shelf software (COTS).
The system will be used by the Department of Insurance's Fraud Division, whose detectives are tasked with detecting and investigating cases suspected insurance fraud. The division receives 32,000 suspected insurance fraud referrals a year, according to the Department of Insurance.
The Fraud Division's staff of more than 275 people investigates fraud in auto insurance, workers' compensation, disability and health-care fraud, and other instances.
The FDAS project has moved through the first stage of the Department of Technology's project approval process, and market research for the solution is being done through a Request for Information that's active. Final responses to the RFI are due Sept. 16.
This month the Department of Insurance was recognized with a 2016 Digital Government Achievement Award for its implementation of its online Consumer and Healthcare Provider Portals, followed by a phased rollout of its licensee portal late last year.
