Health Insurance Online :: News
SHARE

Share this news item!

Insurance Industry Arms with AI to Outpace Scams

Insurance Industry Arms with AI to Outpace Scams

Insurance Industry Arms with AI to Outpace Scams?w=400

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

In an evolving battle against growing fraud, the insurance sector is turning to advanced technology as a solution.
Despite the continuous advancements in fraud prevention, the creativity of scammers puts pressure on insurers to leverage smarter resources.

The Insurance Council of Australia (ICA) reports the insurance industry is burdened by an estimated $400 million in undetected fraudulent claims in 2023. Such costs inevitably burden consumers through higher premiums and collateral economic impacts.

A report from the US National Insurance Crime Bureau cited a staggering $9.2 billion in inflated disaster claims paid out in 2022 due to scams. ICA has reacted by empowering a specialist fraud prevention team under the leadership of former cybercrime detective Andrew Gill to crack down on organised scam operations.

The rising concern is the technological sophistication scammers employ. A new phenomenon known as “shallowfake” scams, highlighted in a recent Allianz warning, shows fraudsters manipulating images using simple tools like Photoshop to simulate damages, complicating genuine claim approval processes.

Diving deeper, the advent of generative artificial intelligence (GenAI) could complicate issues further. From augmenting photographs to creating realistic phishing attacks, GenAI is proving to be a powerful tool for bad actors. As Shift Technology's head of global partnerships, Drew Whitmore explained, fraudulent claims are reported 58% more often by scammers. “The severity of those claims is over eight times more than the standard,” he noted, demonstrating the intensity of the threat.

Social media platforms are not exempt from misuse, with fraudsters mining public information to craft credible yet deceitful claims. Abhi Bhola from EXL expressed that the era of easy access AI is contributing to diverse fraudulent approaches, warning, “Better AI, which is easily available, is fueling the threat.”

Fortunately, artificial intelligence offers a defense mechanism for insurers. By processing and analyzing vast datasets in real time, AI helps insurers promptly detect abnormalities and nefarious activities before they intensify. Collaborations such as the one between EXL and Shift Technology aim to enhance the precision of fraud detection across the sector.

Preserving the integrity of the insurance ecosystem requires proactive cultural transformations, according to Whitmore, If insurers cannot do that, leveraging any advanced technology will not help. He emphasises the necessity of moving from a reactive stance to forecasting and preemptive action.

The industry anticipates more regulatory cooperation in data-sharing strategies to foster effective anti-fraud measures. As Whitmore emphasized: that Fraudsters are sharing their information, and the industry needs a framework to do this, too.

By harnessing AI and building supportive industry partnerships, insurance companies can expect to mitigate fraudulent losses, protect their consumers’ interests, and uphold their role as trustworthy societal figures, thereby exemplifying positive conduct within their communities.

Published:Thursday, 17th Oct 2024
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Surge in Mental Health Claims Reshapes Australia's Insurance Landscape
Surge in Mental Health Claims Reshapes Australia's Insurance Landscape
31 Oct 2025: Paige Estritori
Australia's insurance industry is experiencing a significant shift as mental health conditions have become the leading cause of total and permanent disability (TPD) claims. Recent data from the Council of Australian Life Insurers (CALI) indicates that mental health issues now account for nearly one-third of all TPD claims, marking a substantial change in the industry's claim patterns. - read more
Australian Super's Claim Delays Raise Concerns Among Members
Australian Super's Claim Delays Raise Concerns Among Members
31 Oct 2025: Paige Estritori
Australian Super, one of the nation's largest superannuation funds, is facing criticism over significant delays in processing insurance claims, particularly those related to income protection and total and permanent disability (TPD). Members have reported prolonged waiting periods, leading to financial hardships and uncertainty. - read more
New Legislation Prohibits Life Insurers from Using Genetic Test Results
New Legislation Prohibits Life Insurers from Using Genetic Test Results
31 Oct 2025: Paige Estritori
The Australian government has enacted legislation prohibiting life insurers from using the results of genetic tests to refuse coverage or increase premiums. This landmark decision aims to eliminate genetic discrimination and encourage individuals to undergo potentially life-saving genetic testing without fear of financial repercussions. - read more
Maritime Mutual Under Investigation for Insuring Sanctioned Oil Shipments
Maritime Mutual Under Investigation for Insuring Sanctioned Oil Shipments
31 Oct 2025: Paige Estritori
Recent investigations have revealed that Maritime Mutual, a New Zealand-based insurance company, has been providing coverage to tankers involved in transporting sanctioned Iranian and Russian oil. This development has sparked significant regulatory scrutiny and raised questions about compliance within the marine insurance industry. - read more
EQT's A$5.25 Billion Bid for AUB Group: A Game-Changer in Australian Insurance
EQT's A$5.25 Billion Bid for AUB Group: A Game-Changer in Australian Insurance
31 Oct 2025: Paige Estritori
In a significant development within Australia's insurance sector, Swedish private equity firm EQT has proposed a takeover of AUB Group, valuing the insurance broking company at A$5.25 billion (US$3.41 billion). This offer represents a 25.1% premium over AUB's last closing share price, underscoring EQT's strong interest in expanding its footprint in the Australian market. - read more


Health Insurance Articles

Keeping Your Family Protected: The Importance of Adequate Health Insurance Coverage
Keeping Your Family Protected: The Importance of Adequate Health Insurance Coverage
The modern Australian family faces a dynamic and ever-evolving set of health needs, with access to quality healthcare remaining a cornerstone of managing our wellbeing. As these needs shift through the different stages of life, the assurance of having a safety net in place can provide unparalleled peace of mind. It's this sense of security that makes adequate health insurance coverage indispensable in today's fast-paced society. - read more
Affordable Health Insurance: How to Find the Best Plan for You
Affordable Health Insurance: How to Find the Best Plan for You
Affordable health insurance refers to insurance plans that offer necessary health coverage at a price within one's financial means. These plans aim to balance cost with the quality of care, providing essential services without excessive financial burden. The goal is to make healthcare accessible to a wider population, ensuring that everyone can maintain their health without going into debt. - read more
The Digital Age of Health Insurance: Comparing Policies Online
The Digital Age of Health Insurance: Comparing Policies Online
The dawn of the digital age has significantly transformed the way we approach nearly every aspect of our lives, and the domain of health insurance is no exception. With the arrival of innovative digital tools, the health insurance landscape has undergone a striking evolution, allowing for unprecedented accessibility and convenience in managing healthcare coverage. - read more
5 Common Mistakes to Avoid When Selecting Family Health Insurance
5 Common Mistakes to Avoid When Selecting Family Health Insurance
Choosing the right family health insurance can feel like navigating a maze. With so many options and factors to consider, it's no wonder many Australians find the process overwhelming. The stakes are high, as the wrong choice could not only impact your family's access to healthcare but also strain your finances. - read more
Health Fund Rebates 101: What Every Australian Needs to Know
Health Fund Rebates 101: What Every Australian Needs to Know
Exploring the realm of health insurance can be like navigating a labyrinth, replete with complex terms and varying policies. Among these, health fund rebates emerge as a crucial element, particularly for young Australians embarking on their journey of health coverage. Fund rebates can significantly lighten the financial burden, transforming the quest for health insurance from daunting to empowering. - read more


Your free Heatlth insurance quote comparison starts here!
First Name:
Postcode:

Insurance quotes are provided free and without obligation by a specialist from our national broker referral network. See our privacy statement for more details.


Knowledgebase
Umbrella Policy:
An additional insurance policy that provides extra liability coverage beyond the limits of the insured's primary policies.