Fraud Prevention

Prevent insurance fraud with these 2 technologies

It is known from FBI reports that insurance frauds (excluding health insurance) costs more than $40 billion a year only in the United States.

However, if we add health insurance costs, the total amount of insurance in the U.S. market exceeds $100 billion.

Under this premise, there is a clear need to protect the insurance industry in the face of the great wave of fraud that is occurring all the time. If this is not curbed, the consequences extend to a long list.

For all these reasons, in this article we will explain which technologies are necessary for the insurance industry to prevent fraud.

How can we prevent fraud?

First, it should be made clear that frauds are not something that only affects insurance companies; on the contrary, it has a negative impact on their policyholders as well.

Part of the financial cost of frauds is reflected for policyholders in the form of higher premiums.

Now, starting from this point, let’s explore these two technologies that we can implement in our insurer to curb fraud and its consequences:

01. Artificial Intelligence

The insurance companies that uses some types of Machine learning (ML), are capable of identifying similities betweens} previous fraudulent actions.

Insurance companies can classify each case as fraud or non-frauds. Over time, ML models find the parameter values that indicate a suspicious claim and flag them for further investigation.

It should also be made clear that fraudsters are always devising new fraud schemes. Supervised ML models may be ineffective at detecting new types of fraud, while unsupervised models are good at detecting anomalies.

Behavioral Analysis

According to the article from AI Multiple, is a new tool that insurers can use to combat insurance fraud.

These provide information about people’s actions by tracking and interpreting their browsing history, clicks, location, etc. They also help insurers determine whether policyholders’ claims are reliable or not.

02. Chatbots: Let’s speed up the processing of claims.

These customer assistants are driven by Natural Language Processing and the accelerate the claims processing. Today, it is possible to send the First Notification of Lost (FNOL) following the chatbot instructions. 

In consecuences, the first step of the claim processing is completed inmediatly without the necessity of involving a human expert.

The chatbots drive the customers to take pictures and videos of the damage and this, give the potencial scamers less times to change the data.

In a nutshell, thanks to the inmediate FNOL, the scammer can not tamper the original data. Therefore, the probability of false claims is reduced.


While it is true that insurers have undergone a very slow metamorphosis, they need to continue adopting technology.

Technology makes our lives simpler and also protects us from not so pleasant situations such as fraud.

Get to know LISA Claims! With our flagship product you will be able to prevent fraud during the entire claims settlement process thanks to the use of AI and the chatbot where the FNOL will be carried out.

Get to know us! It’s totally free and you won’t regret it.

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