Systems and methods for a multi-tiered fraud alert review

• US 10,467,632 B1
• Filed: 12/13/2017
• Issued: 11/05/2019
• Est. Priority Date: 12/13/2016
• Status: Active Grant

• Current Assignee: Massachusetts Mutual Life Insurance Company
• Original Assignee: Massachusetts Mutual Life Insurance Company
• Inventors: Merritt, Sears
• Primary Examiner(s): Lwin, Maung T
• Application Number:
  US15/840,957
• Time in Patent Office: 692 Days
• Field of Search: None
• CPC Class Codes: G06Q 30/0185 Product, service or business identity fraud

Abstract

Embodiments of systems and methods for fraud review are disclosed. The systems may comprise multi-tiered computing systems which may receive fraud alerts from multiple sources. A computing system in a tier may receive a fraud alert and use one or more fraud risk metrics to determine whether the fraud alert should be escalated. If the computing system determines that the fraud alert should be escalated, the computing system may transmit an escalation message to a higher tier computing system. If the computing system determines that the fraud alert should not be escalated, the computing system may transmit a message to a fraud prevention computing system. In some embodiments, the computing system may determine that the fraud alert is a false positive and transmit a false positive message to the source of the fraud alert such as a lower tier computing system.

Claims

1. A computer-implemented method comprising:

receiving, by a first level computing system, a first level fraud alert notification message from a webserver;

retrieving, by the first level computing system, one or more data records associated with the first level fraud alert notification message and one or more data records of first level fraud risk metrics from a first level risk database;

determining, by the first level computing system, a first level fraud risk score based upon the one or more data records associated with the first level fraud alert notification message and the one or more data records of the first level fraud metrics;

upon determining by the first level computing system that the first level fraud risk score exceeds a first level fraud threshold;

generating, by the first level computing system, a second level fraud alert notification message, wherein the second level fraud alert notification message includes one or more data fields indicating an escalation of the first level fraud alert notification message;

transmitting, by the first level computing system, the second level fraud alert notification message to a second level computing system, wherein the second level computing system is at a higher tier than the first level computing system;

transmitting, by the first level computing system, a stop execution message to the webserver, wherein the stop execution message instructs the webserver to stop executing computer operations associated with the first level fraud alert notification message; and

upon determining by the first level computing system that the first level fraud risk score is below the first level fraud threshold;

transmitting, by the first level computing system, a continue execution message to the webserver, wherein the continue execution message instructs the webserver to continue executing computer operations associated with the first level fraud alert notification message.

2. The computer-implemented method of claim 1, further comprising:

receiving, by the second level computing system, the second level fraud alert notification message;

retrieving, by the second level computing system, data records associated with the second level fraud alert notification message and one or more data records of second level fraud risk metrics;

determining, by the second level computing system, a second level fraud risk score based upon the one or more data records associated with the second level fraud alert notification message and the one or more data records of the second level fraud metrics;

generating, by the second level computing system, a fourth level fraud alert notification message in response to determining that the second level fraud risk score exceeds a second level fraud threshold; and

transmitting, by the second level computing system, the fourth level fraud alert notification message to a fourth level computing system.

3. The computer-implemented method of claim 2, further comprising, wherein the fourth level computing system is at a higher tier than the second level computing system.

4. The computer-implemented method of claim 2, further comprising:

generating, by the second level computing system, a second level false positive notification message in response to determining that the second level fraud risk score is below the second level fraud threshold; and

transmitting, by the second level computing system, the second level false positive notification message to the first level computing system.

5. The computer-implemented method of claim 2, further comprising:

transmitting, by the second level computing system, a notification message to one or more law enforcement computer systems in response to determining that the second level fraud score risk is above the second level fraud threshold.

6. The computer-implemented method of claim 2, wherein the first level, second level, third level, and fourth level computing systems are associated with a common database.

7. The computer-implemented method of claim 2, further comprising:

receiving, by the second level computing system, one or more manual updates to the second level fraud metrics; and

updating, by the second level computing system, the second level fraud risk metrics based upon the one or more manual updates.

8. The computer-implemented method of claim 2, further comprising:

receiving, by the second level computing system, one or more automated updates to the second level fraud metrics from a fraud prevention server; and

updating, by the second level computing system, the second level fraud risk metrics based upon the one or more automated updates.

9. The computer-implemented method of claim 1, further comprising:

receiving, by the first level computing system, one or more manual updates to the first level fraud metrics; and

updating, by the first level computing system, the first level fraud risk metrics based upon the one or more manual updates.

10. The computer-implemented method of claim 1, further comprising:

receiving, by the first level computing system, one or more automated updates to the first level fraud metrics from a fraud prevention server; and

updating, by the first level computing system, the first level fraud risk metrics based upon the one or more automated updates.

11. A system comprising:

a first level risk database;

a first level computing system, comprising a memory and a processor executing instructions stored in the memory, configured to;

receive a first level fraud alert notification message from a webserver;

retrieve one or more data records associated with the first level fraud alert notification message and one or more data records of first level fraud risk metrics from the first level risk database;

determine a first level fraud risk score based upon the one or more data records associated with the first level fraud alert notification message and the one or more data records of the first level fraud metrics;

upon determining that the first level fraud risk score exceeds a first level fraud threshold;

generate a second level fraud alert notification message, wherein the second level fraud alert notification message includes one or more data fields indicating an escalation of the first level fraud alert notification message;

transmit the second level fraud alert notification message to a second level computing system, wherein the second level computing system, comprising a memory and a processor executing instructions stored in the memory, is at a higher tier than the first level computing system;

transmit a stop execution message to the webserver, wherein the stop execution message instructs the webserver to stop executing computer operations associated with the first level fraud alert notification message; and

upon determining that the first level fraud risk score is below the first level fraud threshold;

transmit a continue execution message to the webserver, wherein the continue execution message instructs the webserver to continue executing computer operations associated with the first level fraud alert notification message.

12. The system of claim 11 wherein the second level computing system is further configured to:

receive the second level fraud alert notification message;

retrieve data records associated with the second level fraud alert notification message and one or more data records of second level fraud risk metrics;

determine a second level fraud risk score based upon the one or more data records associated with the second level fraud alert notification message and the one or more data records of the second level fraud metrics;

generate a fourth level fraud alert notification message in response to determining that the second level fraud risk score exceeds a second level fraud threshold; and

transmit the fourth level fraud alert notification message to a fourth level computing system.

13. The system of claim 12, wherein the fourth level computing system is at a higher tier than the second level computing system.

14. The system of claim 12, wherein the second level computing system is further configured to:

generate a second level false positive notification message in response to determining that the second level fraud risk score is below the second level fraud threshold; and

transmit the second level false positive notification message to the first level computing system.

15. The system of claim 12, wherein the second level computing system is further configured to:

transmit a notification message to one or more law enforcement computer systems in response to determining that a second level fraud risk is above the second level fraud threshold.

16. The system of claim 12, wherein the first level, second level, third level, and fourth level computing systems are associated with a common database.

17. The system of claim 12, wherein the second level computing system is further configured to:

receive one or more manual updates to the second level fraud metrics; and

update the second level fraud risk metrics based upon the one or more manual updates.

18. The system of claim 12, wherein the second level computing system is further configured to:

receive one or more automated updates to the second level fraud metrics from a fraud prevention server; and

update the second level fraud risk metrics based upon the one or more automated updates.

19. The system of claim 11, wherein the first level computing system is further configured to:

receive one or more manual updates to the first level fraud metrics; and

update the first level fraud risk metrics based upon the one or more manual updates.

20. The system of claim 11, wherein the first level computing system is further configured to:

receive one or more automated updates to the first level fraud metrics from a fraud prevention server; and

update the first level fraud risk metrics based upon the one or more automated updates.