Fraud is becoming a bigger problem for the insurance industry in the digital age. Insurance fraud damages policyholders’ trust in insurers and is not simply expensive. The complex strategies used by fraudsters are surpassing the effectiveness of traditional methods of fraud detection, even though they are still useful to some degree. Herein lies the role of artificial intelligence (AI), which provides a potent remedy to improve fraud detection and prevention.

Understanding Insurance Fraud

Insurance fraud can take many different forms, such as inflated losses or fabricated claims. All insurance kinds are impacted, including life, health, vehicle, and property insurance. The FBI estimates that, excluding health insurance, the annual cost of insurance fraud is above $40 billion, which results in increased rates for policyholders and large losses for insurers.

The Limitations of Traditional Fraud Detection

Conventional techniques for detecting fraud mostly rely on rule-based systems and human procedures. Although these techniques can spot established fraud tendencies, they frequently miss novel and developing strategies. Rule-based systems have the potential to produce a large number of false positives, which can result in inefficiencies and higher operational costs. Manual reviews take a lot of time and are prone to human mistake.

Read more : The Role of AI in Enhancing Fraud Detection in Insurance