Data 610 Milestone One (2)

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Southern New Hampshire University *

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Apr 3, 2024

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Tucker 1 Katherine Tucker Data 610 Optimization and Risk Assessment Develop an Operational Risk Management Proposal Professor Camac Milestone 1

Tucker 2 Background and Goals Company XYZ is a property and casualty insurance agency. Company XYZ uses data analytics to manage market, credit, and insurance risks. The company completed a risk and control assessment and found that their operations losses were much greater. “Operational risk management had been defined in the past as all risk that is not captured in market and credit risk management programs” (Girling, P.X, 2022). They aim to have an operational risk management program that performs at the same high level as its other risk programs. They then would like a single chief risk officer to all report to. The company needs to address the understaffing and is unable to handle the high volume of auto accident bodily injury claims. Company XYZ wants to address the operational losses with these claims and better rank the claims that are most suspicious to address first. Lastly, they identified needing to invest more time and money into the risk management system as a whole. Established Programs, Policies, Strategies and Practices Company XYZ already has a Special Investigations Unit (SIU) that investigates claims that are suspected of being fraudulent. Currently, the company sends all the claims through the risk management chief officer. The company will need to invest in the risk management system by increasing and improving the program. The Chief Risk Officer will oversee all risk management and track the performance of each program. Recommended Techniques and Practices Breaking up risk management into smaller divisions will assist in managing suspicious claims easier than them all going to one single place. Needing to hire more employees to manage the high level of suspicious claims and have the current employees focused on one risk program

Tucker 3 and have general knowledge of all claims. Creating a program that filters all incoming claims sent to specific groups and then prioritizing the level of suspicion. Support for Enhancement of Risk Assessment Potential Enhancement of risk assessment is critical for the company to manage the high value of fraudulent automobile accident personal injury claims. Company XYZ understands the importance of analytic techniques and using them to improve the success of data management, identifying concerns, and assisting employees in monitoring and predicting fraudulent claims which will improve the overall effectiveness of the claim processing. Resources Girling, P. X. (2022). Operational Risk Management (2nd ed.). Wiley Professional Development (P&T). https://mbsdirect.vitalsource.com/books/9781119836056

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