A new survey has revealed that fraud remains a top concern for insurers globally and the number of fraud cases is either holding steady or increasing compared to previous years.
The 2024 Global Claims Fraud Survey conducted online by the Reinsurance Group of America found that despite continued efforts to detect and prevent it, fraud remains one of the most significant risks for life and health insurers. It, however, says that while AI has opened new opportunities for fraudsters, it also gives insurers new tools with which to identify and combat fraud.
The largest proportion of responses (60%) to the second edition of the online survey that was conducted during 2023 came from the Asia Pacific region, including Australia and New Zealand, followed by the Americas and Europe, Middle East, and Africa (EMEA) regions. The first survey was conducted in 2017.
According to the 2024 survey, fraud is the top concern among respondents for claims processing across all regions.
The survey found that consumer (72%) and agent-assisted (42%) frauds were top concerns for insurers. Also, individuals or teams assigned to investigate fraud were reported by 78% of respondents, an increase of 15% from 2017 survey findings.
The top fraud indicators used by insurers included early claims; industry-assisted fraud (agents, doctors, hospitals, others); unreasonable, inconsistent, or suspicious explanations and industry or company databases/checks.
The survey revealed that the top challenges with regard to investigating fraud globally included difficulty in obtaining evidence; resistance from claimants, doctors, and other relevant parties in cooperating with investigators; and personal data protection laws.
Almost half (48%) of the respondents reported AI-aided fraud conducted to produce falsified medical or death records; they expressed less concern about deepfake photography, AI-assisted diagnosis, and voice cloning.
The survey found that 82% of the companies provide fraud recognition training for claims assessors. Two thirds of the respondents said that they utilise fraud detection tools, such as industry databases and established fraud indicators.
RGA suggested that insurers could still improve their fraud prevention strategies by conducting proactive fraud assessments on in-force portfolios.
Source: asiainsurancereview.com
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