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
Author: Paige Estritori

Please Note: We do not endorse any specific products or companies. Some content is sourced from third parties, including press releases, and may not be independently verified for accuracy or completeness.

Share this news item:

Rate this article

0 Comments

No comments yet. Be the first to share your thoughts.

Insurance News

Northern Strata Schemes Face Fresh Scrutiny on Cyclone Cover
Northern Strata Schemes Face Fresh Scrutiny on Cyclone Cover
25 Jul 2026: Paige Estritori
A fresh review of Australia’s cyclone reinsurance pool has put northern strata insurance affordability back in focus, particularly for apartment buildings and mixed-use schemes exposed to cyclone, flood and storm surge risk. The pool was designed to improve insurer capacity and ease premium pressure in cyclone-prone regions, but the latest discussion suggests that outcomes are still uneven for complex strata properties. - read more
Why Insurance Tax Reform Is Back in Focus for Small Operators
Why Insurance Tax Reform Is Back in Focus for Small Operators
25 Jul 2026: Paige Estritori
A renewed industry push to reduce or remove state-based insurance taxes has put affordability back in the spotlight for Australian small businesses. For domestic and home service operators, the issue is practical rather than political: when premiums rise, it becomes harder to maintain the cover needed to work safely in clients’ homes, meet contract requirements and protect tools, vehicles and income. - read more
What Rising Insurance Complaints Mean for Freelancers
What Rising Insurance Complaints Mean for Freelancers
25 Jul 2026: Paige Estritori
Australia’s financial complaints landscape is sending a clear message to insurance customers: the moment to understand a policy is before something goes wrong. Recent Australian Financial Complaints Authority data shows complaint volumes remain historically high across financial services, with insurance disputes continuing to form a significant part of the workload. - read more
What the Next Phase of the Insurance Code Review Means for Trainers
What the Next Phase of the Insurance Code Review Means for Trainers
25 Jul 2026: Paige Estritori
The public consultation period for the redrafted General Insurance Code of Practice has now passed, moving Australia’s insurance sector into the next stage of review and refinement. For personal trainers, fitness instructors and small studio operators, this is not a technical issue reserved for insurers. It is a practical reminder that the way claims are handled can be just as important as the cover purchased in the first place. - read more
Advice Access Reforms Put Life Cover Decisions in Focus
Advice Access Reforms Put Life Cover Decisions in Focus
25 Jul 2026: Paige Estritori
The latest stage in Australia’s financial advice reform agenda has put a practical question back in front of the life insurance sector: how can people get timely, affordable help before they buy, change or cancel cover? The reforms are intended to make simpler forms of guidance easier to provide, while keeping consumer protections in place for decisions that can affect a family’s financial resilience for decades. - read more


Health Insurance Articles

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
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
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
Is Private Health Insurance Worth It? Exploring the Benefits
Is Private Health Insurance Worth It? Exploring the Benefits
In Australia, health insurance plays a significant role in ensuring individuals can access quality medical care without incurring prohibitive costs. - 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

Knowledgebase
Insurance Deductible:
That part of an insurance claim that must be paid by an insured person before the the balance is paid by the insurer.