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

New Draft Insurance Code Puts Motor Claim Delays in Focus
New Draft Insurance Code Puts Motor Claim Delays in Focus
25 Jun 2026: Paige Estritori
Australias general insurance sector is facing a proposed step-up in accountability, with the Insurance Council of Australia opening consultation on a new draft General Insurance Code of Practice on 24 June 2026. For truck owners, small fleet operators and transport businesses, the most relevant shift is not just the wording of the code, but the possibility that parts of it could become contractually enforceable for the first time, subject to ASIC approval. - read more
Income Protection Demand Rises as Australians Revisit Personal Cover
Income Protection Demand Rises as Australians Revisit Personal Cover
24 Jun 2026: Paige Estritori
New market data points to a meaningful lift in Australians taking out individual income protection insurance, suggesting more households are reassessing how they would manage financially if illness or injury interrupted their pay. - read more
Claims Delays Put Life Insurance Service Standards in Focus
Claims Delays Put Life Insurance Service Standards in Focus
24 Jun 2026: Paige Estritori
A recent sanction against an unnamed life insurer has put claims handling back under the spotlight, particularly for Australians who rely on personal insurance as a financial safety net. The Life Insurance Code Compliance Committee found that the insurer failed to request required information from claimants at the earliest available opportunity, contributing to significant delays for some customers waiting on claim decisions. - read more
Draft Insurance Code Puts Claims Standards Back in Focus
Draft Insurance Code Puts Claims Standards Back in Focus
24 Jun 2026: Paige Estritori
The Insurance Council of Australia has released a draft General Insurance Code of Practice for feedback, marking a significant step in the industry’s push to strengthen customer protections. Released on 24 June 2026, the draft is open for consultation until 21 July 2026 and is designed to make key obligations legally enforceable through insurance contracts. - read more
New Crane Cover Highlights the Insurance Gap for High-Risk Trades
New Crane Cover Highlights the Insurance Gap for High-Risk Trades
24 Jun 2026: Paige Estritori
A new specialist insurance product for Australian crane and rigging operators is a timely reminder that not every business fits neatly into a standard policy box. ARTes Specialty, working with wholesale provider Mobius Insurance, has launched an integrated crane and rigging policy for the local market, adding to its earlier Australian offerings for commercial loggers and contractors plant and equipment. - read more


Health Insurance Articles

The Importance of Comparing Health Insurance Extras for Maximum Savings
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
What to Look for in Basic Health Insurance Cover
What to Look for in Basic Health Insurance Cover
Welcome to our discussion on basic health insurance cover, a topic that is crucial yet often overlooked in the hustle and bustle of everyday life. Navigating the world of health insurance can be daunting, but understanding your options is vital for peace of mind and financial stability. - read more
Top 10 Tips to Find Affordable Health Insurance in Australia
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 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
Understanding the Basics of Australian Health Insurance
Understanding the Basics of Australian Health Insurance
Health insurance is a critical part of maintaining your well-being and financial stability. In Australia, understanding the basics of health insurance can help you make informed decisions that protect you during unforeseen medical events. - read more

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