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How AI uncovers fraud in high volume, low value claims

Though inexpensive and not cost effective to investigate, the fraud losses on these claims quickly add up.

By Gary Saarenvirta | May 10, 2022 at 02:00 AM
Outline of a brain overlaid on a circuit board. Ultimately, utilizing AI technology means the low value claims that could not be investigated previously, suspicious or otherwise, can now be taken on by the AI system — alleviating the strain on insurers and saving them from paying millions in fraudulent claims. (Credit: cono0430/Shutterstock)

Facing continued uncertainty and instability, insurers are greatly challenged to fight emerging fraud and its effects across insurance organizations. In addition to pandemic-related challenges, insurers must also juggle shifting customer needs, behaviors and expectations as customers continue to demand faster and better service from their providers.

With resources stretched thin, special investigations teams don’t have the capacity to review low-value claims (i.e., claims for minor windshield damage) and instead write them off. Though inexpensive and not cost effective to investigate, the fraud losses on these claims quickly add up – especially as fraudulent activity continues to increase.

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