Insurance Industry Arms with AI to Outpace Scams

3

The information on this website is general in nature and does not take into account your objectives, financial situation, or needs. Consider seeking personal advice from a licensed adviser before acting on any information.

The Insurance Council of Australia (ICA) reports the insurance industry is burdened by an estimated $400 million in undetected fraudulent claims in 2023. Such costs inevitably burden consumers through higher premiums and collateral economic impacts.

A report from the US National Insurance Crime Bureau cited a staggering $9.2 billion in inflated disaster claims paid out in 2022 due to scams. ICA has reacted by empowering a specialist fraud prevention team under the leadership of former cybercrime detective Andrew Gill to crack down on organised scam operations.

The rising concern is the technological sophistication scammers employ. A new phenomenon known as “shallowfake” scams, highlighted in a recent Allianz warning, shows fraudsters manipulating images using simple tools like Photoshop to simulate damages, complicating genuine claim approval processes.

Diving deeper, the advent of generative artificial intelligence (GenAI) could complicate issues further. From augmenting photographs to creating realistic phishing attacks, GenAI is proving to be a powerful tool for bad actors. As Shift Technology's head of global partnerships, Drew Whitmore explained, fraudulent claims are reported 58% more often by scammers. “The severity of those claims is over eight times more than the standard,” he noted, demonstrating the intensity of the threat.

Social media platforms are not exempt from misuse, with fraudsters mining public information to craft credible yet deceitful claims. Abhi Bhola from EXL expressed that the era of easy access AI is contributing to diverse fraudulent approaches, warning, “Better AI, which is easily available, is fueling the threat.”

Fortunately, artificial intelligence offers a defense mechanism for insurers. By processing and analyzing vast datasets in real time, AI helps insurers promptly detect abnormalities and nefarious activities before they intensify. Collaborations such as the one between EXL and Shift Technology aim to enhance the precision of fraud detection across the sector.

Preserving the integrity of the insurance ecosystem requires proactive cultural transformations, according to Whitmore, If insurers cannot do that, leveraging any advanced technology will not help. He emphasises the necessity of moving from a reactive stance to forecasting and preemptive action.

The industry anticipates more regulatory cooperation in data-sharing strategies to foster effective anti-fraud measures. As Whitmore emphasized: that Fraudsters are sharing their information, and the industry needs a framework to do this, too.

By harnessing AI and building supportive industry partnerships, insurance companies can expect to mitigate fraudulent losses, protect their consumers’ interests, and uphold their role as trustworthy societal figures, thereby exemplifying positive conduct within their communities.

Published:Thursday, 17th Oct 2024
Source: Paige Estritori

Please Note: If this information affects you, seek advice from a licensed professional.

Share this news item:

Insurance News

Clear

NSW Introduces Strata Law Reforms to Strengthen Community Governance

19 Nov 2025: Paige Estritori

On 27 October 2025, the New South Wales (NSW) Government implemented significant reforms to strata laws, aiming to enhance transparency, accountability, and financial management within strata schemes. These changes are designed to better meet the evolving needs of strata communities across the state. - read more

Strata Insurance Affordability Holds Steady Despite Rising House Insurance Costs

19 Nov 2025: Paige Estritori

In its 2025 State of the Strata Market report, CHU has revealed that strata insurance premiums have experienced a modest increase of 2.8%, rising to an average of $981 per lot in the year leading up to June 2025. This increment is notably lower than the 14% surge observed in house insurance premiums during the same period. - read more

Consumer Advocates Push for Ban on Strata Insurance Commissions in NSW

19 Nov 2025: Paige Estritori

Consumer advocacy groups, including the Australian Consumers Insurance Lobby (ACIL) and the Owners Corporation Network (OCN), are urging the New South Wales (NSW) Government to implement a ban on commissions related to strata insurance. They argue that such commissions create conflicts of interest and compromise transparency within the strata management sector. - read more

AFCA Criticises TAL for Unfair Termination of Income Protection Benefits

16 Nov 2025: Paige Estritori

The Australian Financial Complaints Authority (AFCA) has recently ruled against TAL, a prominent life insurer, for terminating a policyholder's income protection benefits without prior notice. This decision underscores the critical importance of procedural fairness in the management of insurance claims. - read more

Actuaries Institute Highlights Financial Strain of Mental Illness on Insurance Systems

16 Nov 2025: Paige Estritori

The Actuaries Institute has issued a call for immediate action to address the escalating financial strain that mental illness is placing on Australia's insurance and compensation systems. This appeal underscores the pressing need to ensure the sustainability of the nation's financial safety net in the face of increasing mental health-related claims. - read more

Click for more Insurance News