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

Heightened Road Risks During Holiday Season: Insurers Issue Warnings
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
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
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
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
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


Health Insurance Articles

Insider Secrets to Finding Cost-Efficient Health Insurance
Insider Secrets to Finding Cost-Efficient Health Insurance
Health insurance in Australia is a crucial aspect of ensuring you and your family receive the medical care needed without facing exorbitant costs. The healthcare system, consisting of both public and private sectors, offers various options to suit different needs and budgets. While the public sector (Medicare) provides essential services, private health insurance offers additional benefits such as faster access to services, choice of doctor, and coverage for services not included in Medicare. - read more
Smart Strategies to Lower Your Health Insurance Premiums
Smart Strategies to Lower Your Health Insurance Premiums
In today's rapidly changing health insurance landscape in Australia, keeping track of costs and coverage can be daunting. Many Australians find themselves grappling with high premiums that seem to increase year after year. - 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
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
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


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
Coverage:
The amount of risk or liability covered for an individual or entity by way of insurance services.