Health Insurance Online :: News

Share this news item!

Insurance Industry Arms with AI to Outpace Scams

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

Heightened Road Risks During Holiday Season: Insurers Issue Warnings

19 Dec 2025: Paige Estritori

As the Australian summer school holidays coincide with peak freight activity, insurers and transport specialists are raising concerns about heightened road risks. The surge in freight traffic, coupled with increased holiday travel, amplifies the potential for road incidents, particularly involving heavy vehicles. - read more

Rising Collision Risks Challenge Australian Fleet Operators

19 Dec 2025: Paige Estritori

Australia's transport and haulage sector is currently navigating a period of heightened operational risk, marked by an uptick in both the frequency and severity of motor collision claims. This trend underscores the pressing need for fleet operators to adopt proactive risk management strategies and leverage advanced insurance solutions to safeguard their operations. - read more

Australian Life Insurance Premiums Set for 1.7% Growth in 2025

18 Dec 2025: Paige Estritori

According to a recent report by Swiss Re, Australia's life insurance market is projected to experience a 1.7% real growth in premiums in 2025. This anticipated increase is attributed to easing cost-of-living pressures and the repricing of disability income policies. - read more

TAL's Health Sense Plus Now Covers Income Protection Policies

18 Dec 2025: 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 incentivize proactive health management by offering premium discounts to clients who engage in preventive health checks. - read more

Pelagic Risk Services Strengthens Commitment to Marinas with Gold Sponsorship

18 Dec 2025: Paige Estritori

In a significant move to bolster support for the marina industry, Pelagic Risk Services has elevated its sponsorship status from Silver to Gold with the Marina Industries Association (MIA). This advancement underscores Pelagic's dedication to enhancing the operational capabilities and risk management strategies of marina operators across Australia. - read more

Click for more Insurance News

Health Insurance Articles

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

Top 10 Tips to Find Affordable Health Insurance in Australia

Finding affordable health insurance can be a daunting task, particularly in a landscape as diverse as Australia’s. With a myriad of options available, it's crucial to understand the financial support mechanisms in place that can ease the burden of healthcare costs. One such mechanism is the health fund rebate, a key feature of the Australian health insurance system designed to make healthcare more accessible. - read more

5 Tips to Save on Health Cover as an Australian Senior

Finding the right health insurance coverage is a critical concern for Australian seniors, who often face the dual challenge of managing chronic health conditions and maintaining financial stability in retirement. As the cost of healthcare continues to rise, the importance of securing an affordable health cover that still meets their needs cannot be overstated. - read more

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

The Importance of Comparing Health Insurance Extras for Maximum Savings

Health insurance is more than just a precautionary measure; it's a vital component in managing both your health and financial well-being. In Australia, where healthcare costs can quickly escalate, health insurance extras serve as a buffer, ensuring that services like dental, optical, and physiotherapy remain within reach. These extras can significantly reduce the out-of-pocket expenses you might otherwise encounter for non-hospital treatments. - read more

Knowledgebase

Exclusion:
Specific conditions or circumstances for which the insurance policy does not provide coverage.

This website is owned and operated by Clark Family Pty Ltd (ACN 010 281 008) as Trustee for the Clark Family Trust (ABN 35 957 893 714), 43 Larch Street Tallebudgera QLD 4228. Clark Family Pty Ltd is an Authorised Representative (AR 1298860) of Unique Group Broker Services Pty Ltd (AFSL 509434) for financial product referrals and an Authorised Credit Representative (ACR 401491) of Saccasan Pty Ltd (ACL 386297). Check our licensing details on the ASIC registers: Clark Family Pty Ltd ACR, Clark Family Pty Ltd AR, Saccasan Pty Ltd, Unique Group Broker Services.

IMPORTANT: We do not provide financial product advice or credit assistance. We act solely as an introducer and refer enquiries to licensed third-party intermediaries, insurers, and lenders - with whom you can then deal directly. We may receive a fee or commission from these third parties in consideration for the referral. Before any action is taken to obtain a product or service referred to by this website, advice should be obtained (from either the third party to whom we refer you or from another qualified intermediary) as to the appropriateness of obtaining those products having regard to your objectives, financial situation and needs. Whilst we have our own process for validating the legitimacy of our referral partners, you should always verify the credentials of your financial adviser before proceeding with recommendations that they may present. Visit the ASIC website for further information.