Strategies to Combat Insurance Fraud With AI and Specialized Training

Insurance fraud is a growing problem, costing U.S. insurers over $300 billion annually, a significant increase from earlier decades. The rise in fraud is driven by advances in technology, such as deepfakes, that allow fraudsters to exploit claims systems more effectively. Simultaneously, the claims-handling workforce is shrinking, making it harder for adjusters to keep up with identifying fraud manually.

A multi-pronged strategy is emerging as the key to combating insurance fraud. Insurers are increasingly using AI and machine learning tools to identify suspicious activity within claims, enabling faster and more accurate detection of fraud. These technologies can process vast amounts of data, spot patterns, and streamline claims processes, leading to significant cost savings. Beyond technology, insurers are focusing on comprehensive fraud training for staff, helping them stay informed about new fraud trends and equipping them with the skills needed to fight back.

According to Kevin Lederer, Senior Vice President at Davies Group, combining AI, regular fraud training, and partnerships with industry organizations like the National Insurance Crime Bureau will help insurers reduce fraudulent claims and financial losses. Despite the challenges, insurers continue to refine their strategies to stay ahead of ever-evolving fraud schemes.