Insurance companies are leveraging AI to combat claims fraud while grappling with criminals using the same tools to exploit vulnerabilities, driving an urgent need for innovation.

A Florida company, accused of misclassifying Minnesota workers, settles for $300,000 and halts operations in the state, addressing worker misclassification and lost benefits.

A man from Coral Springs, Florida, is under investigation for insurance fraud after allegedly filing a false claim for Hurricane Irma damages, with encouragement from their public adjuster.

American Transit Insurance Co. has filed a $450 million lawsuit against over 180 healthcare providers under the RICO Act, alleging no-fault insurance fraud, kickbacks, and overbilling in New York.

The Consumer Financial Protection Bureau has sued JPMorgan Chase, Bank of America, and Wells Fargo, alleging insufficient protections against fraud on the Zelle payment platform, impacting consumers nationwide.

Artificial intelligence is reshaping workers’ compensation by improving fraud detection, streamlining claims processes, and enhancing injury prevention—but ethical implementation is key.

The DOJ alleges CVS pharmacies knowingly dispensed opioids unsafely, ignoring red flags and understaffing stores, as part of a whistleblower suit under the False Claims Act.

Darren Reeves Roofing is ordered to cease unlicensed public adjuster services, including negotiating insurance claims or offering advice on insurance contracts, following a consent order in Iowa.

Fueled by AI, ML, and big data analytics, the global insurance fraud detection market is projected to grow at a CAGR of 25%, with strong demand from Europe, North America, and APAC.

A former insurance agent in Cupertino has been charged with fraud after allegedly claiming over $900,000 in long-term care benefits for herself and her father under false pretenses.

Authorities have arrested a teenager linked to the Scattered Spider gang, accusing them of hacking financial and telecom firms and launching phishing campaigns targeting employees and customers.

Artificial intelligence is transforming the insurance industry by automating processes, enhancing fraud detection, personalizing policies, and streamlining customer service.

A Missouri farmer, known for his role in a reality TV series, has pleaded guilty to a multi-million-dollar crop insurance fraud scheme involving falsified federal benefit claims.

A Greensboro woman faces charges for allegedly filing a $49,000 claim for pre-existing damage to her late mother’s home, using her mother’s identity to obtain the policy.

Beckett Grading Services faces a steep drop in card grading activity as its owner’s $2 billion insurance fraud conviction compounds ongoing struggles in the competitive market.