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

TAL's Health Sense Plus Now Covers Income Protection Policies
TAL's Health Sense Plus Now Covers Income Protection Policies
04 Feb 2026: Paige Estritori
In a significant development for policyholders, TAL has expanded its Health Sense Plus program to encompass income protection (IP) policies. This initiative, effective from August 8, 2025, aims to incentivise proactive health management by offering premium discounts to clients who engage in preventative health checks. - read more
Surge in Mental Health Claims Puts Pressure on Australia's Insurance Industry
Surge in Mental Health Claims Puts Pressure on Australia's Insurance Industry
04 Feb 2026: Paige Estritori
Australia's insurance sector is facing unprecedented challenges 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) reveals that mental health issues now account for nearly one-third of all TPD claims paid out. - read more
Rest Super Faces Class Action Over Alleged Wrongful Deduction of Income Protection Premiums
Rest Super Faces Class Action Over Alleged Wrongful Deduction of Income Protection Premiums
04 Feb 2026: Paige Estritori
Shine Lawyers has initiated class action proceedings in the Federal Court against Rest Superannuation, alleging that the fund wrongfully deducted income protection premiums from members' accounts between December 2008 and June 2019. The lawsuit claims that up to 500,000 Rest members may have been affected by these deductions. - read more
Marine Skippers Insurance Expands to International Waters
Marine Skippers Insurance Expands to International Waters
04 Feb 2026: Paige Estritori
Marine Skippers Insurance has recently unveiled a new international coverage plan tailored for captains navigating vessels to and from Australia. This development is particularly timely, coinciding with preparations for the upcoming Sydney to Hobart yacht race. - read more
NM Insurance and Zurich Forge Long-Term Partnership
NM Insurance and Zurich Forge Long-Term Partnership
04 Feb 2026: Paige Estritori
NM Insurance has solidified its position in the marine insurance sector by entering into a five-year agreement with capacity provider Zurich. This strategic partnership is set to bolster NM Insurance's growth trajectory and instill greater confidence among brokers. - read more


Health Insurance Articles

The Benefits of Private Health Insurance for Families: Is It Worth the Cost?
The Benefits of Private Health Insurance for Families: Is It Worth the Cost?
Health insurance is a crucial aspect of financial planning for individuals and families alike. It provides protection against unexpected medical costs and ensures that you have access to necessary healthcare services when you need them most. - 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
Unlocking Affordable Health Insurance: Tips to Reduce Your Premiums
Unlocking Affordable Health Insurance: Tips to Reduce Your Premiums
The current health insurance landscape in Australia can be quite confusing for many people. With numerous options available, it’s not always clear which to choose to balance your budget with your needs. Premiums are on the rise, and Australians are becoming increasingly concerned about the costs of maintaining adequate coverage. - 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
The Ultimate Guide to Comparing Health Insurance Plans in Australia
The Ultimate Guide to Comparing Health Insurance Plans in Australia
Australia is renowned for its iconic landmarks, diverse ecosystems, and robust healthcare system. While the public healthcare system, Medicare, provides essential health services, it might not cover everything. The allure of private health coverage lies in its promise of broader options, reduced wait times, and coverage for services not included in Medicare, like dental and optical care. - read more


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

All quotes are provided free and without obligation by a Specialist from our National Broker referral panel. See our Privacy Statement for more details.


Knowledgebase
Liability Insurance:
Insurance that provides protection from claims arising from injuries or damage to other people or property