By akademiotoelektronik, 26/07/2022
Shift Technology reveals new insurance fraud trends detected by artificial intelligence
Shift Technology unveiled the third volume of its Shift Insurance Perspectives report.Belonging to the very closed unicorns club, the company created in 2014 in Paris uses artificial intelligence and advanced data science techniques to detect suspicious behavior during claims declarations and to automate.With this global vision, Shift Technology offers with this new report concrete examples of significant fraud detected by AI.
Shift Technology has established itself as a flagship player in Assurtech. Grâce à sa technologie, l’entreprise a analysé des centaines de millions de sinistres et a reçu le Prix 2020 de Frost & Sullivan pour “ses bonnes pratiques en matière de solutions de gestion des déclarations conçues pour l’assurance”.Installed in 25 countries, it has the customers of large insurance groups such as AXA, AG2R-La Mondiale, La Macif, etc..In the new edition of its Shift Insurance Perspective report, the company has shared five significant fraud patterns and indicates: “These few examples clearly demonstrate that AI is a technology on which insurers can rely to detect fraud toinsurance and make the right decisions more serenely ”.
Insurance fraud upon subscription of a contract
An insured person has subscribed, 24 hours apart, two insurance policies each covering a passenger vehicle.A few months later, she added to the second contract, 11 luxury cars, via digital self-care tools from the insurer.A link between multiple contracts could be established thanks to AI and thus made it possible to discover that the insured managed a rental application between individuals.She provided vehicles on behalf of the rental companies, which was not part of the guarantees of the contract.This fraud from the subscription was detected and all the contracts were terminated.
Automotive insurance fraud
An insured declared a collision with an animal which caused significant damage on the front of his vehicle.The AI was able to make the link between the claim and a certificate of destruction of a vehicle which indicated the same damage as those declared.The anti-fraud service therefore investigated to find out if the vehicle was already damaged and whether the insured had tried or not to file a false declaration in order to have pre-existing damage repaired.
Health insurance fraud
An organized band has declared many claims, an average amount of more than $ 5,000 each, and requested a reimbursement of medical care and services, supposed to have been received by patients on a trip.The AI has identified connections between network members and detect the falsification of supporting documents, whether hospital reports or medical invoices, pharmacies or medical analyzes ...
Cancellation insurance fraud
An increase in attempts at fraud to the cancellation clauses has been noted since the health crisis.The fraudsters used false medical reports (including positive covid tests), falsified tickets ... to obtain compensation for flights, supposedly, canceled.AI has made it possible to detect suspicious activities by identifying the people involved, thanks to the establishment of connections between the insured and the identification of false documents.
More easily determine everyone's responsibilities in the event of a claim
The AI allowed, following the analysis of the parts of a compensation file, to determine that the fire of a rental apartment was linked to the recent installation, by the owner, of a boiler,which had been the subject of a product recall.The insurer was able to recover with a third party the costs initially incurred to compensate the insured and exonerate it.
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