IBM Fraud Intelligence for Social Services / Social Security

Worldwide, more than $4 trillion is expended annually for social services and social security benefits. The majority of benefits go to those deserving and to those who have contributed and are entitled, but not everyone in receipt of benefits presents true information upon application whether due to deception or to error. Not everyone is who he says he is. Not everyone discloses all sources of income, benefits, assets, accommodation or situations where related persons are receiving benefits. When the intent to deceive is successful, or when application errors go undetected, program dollars are paid to the wrong people.

IBM’s Fraud Intelligence for Government solution presents an active, preventive approach to fraud, abuse and error detection, capable of integration with case management applications so that the right eligibility decisions are made prior to extending benefits. The solution enables organizations to:

• Verify applicant identity upon intake
• Determine if applicant is applying for same benefits
• Determine if applicant is applying for multiple benefits across several programs and jurisdictions
• Uncover hidden relationships between applicants and recipients
• Compare applicant eligibility information across programs to comply with privacy legislation