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Tackling AI-Driven Fraud in Insurance Claims

Tackling AI-Driven Fraud in Insurance Claims

My deepfake fraud journey into insurance

I’ve spent my morning creating an insurance claim for damage to my car. But the damage isn’t real, nor is the cost estimate/invoice, and it isn’t even my car. I don’t think anyone will be able to tell.

The work I’m doing is actually to help an insurance firm improve their detection models as they fight against the rise in deepfake and shallowfake-enabled fraud. With new advanced and accessible AI tools it is easier than ever to fabricate convincing claims, and every insurance firm should be preparing themselves.

AI enabled fraud in Insurance

Insurance is undergoing a digital transformation and one area which has seen substantial change is claims processing. Automated systems make assessments quicker, and online platforms are more convenient for customers. However, these also bring an opportunity for potential fraudsters using the latest deepfake and shallow fake AI tools.

Deepfake Fraud

Leveraging advanced AI, deepfakes produce hyper-realistic but fake audio, video, images or other content. For instance, as noted in a blog by Zurich fraudsters have tried to use deepfake technology to simulate a car accident, including fake damage photos that seemed highly realistic. 

Shallow fake Fraud

Unlike deepfakes, shallowfakes can involve simpler editing techniques—such as altering timestamps, editing documents, or adding fake scratches to vehicle photos. For example, a recent article in the Guardian highlighted a car insurance scam where fraudsters manipulated photos to add fake damage. These edits are easier to produce, yet they can be highly deceptive and effective in misleading claim assessments.

AI tools are becoming increasingly advanced and accessible, lowering the barriers for fraudsters to create convincing content that can be used in claims. Fraudsters don’t need to be experts in photo or video editing. They can easily access AI tools that will create photorealistic images, videos or documents based on simple text prompts.

Poacher turned gamekeeper

While AI can be a tool for potential fraudsters, AI also offers an important weapon in detecting and stopping them. Machine learning algorithms can analyse vast amounts of data to identify patterns indicative of fraud, and image and video forensics can detect anomalies in video or images files that are invisible to the human eye. Here are 3 things we’ve seen leading insurance firms do to reduce fraud levels:

Conclusion

Digital tools are transforming insurance, offering both remarkable benefits and new challenges. While fraudsters are attempting to use AI to exploit these technologies, AI also holds the key to robust defence mechanisms. It is clear what insurers must do: leverage AI’s ability to analyse data for anomaly detection, foster partnerships with leading AI detection companies, and train staff to stay vigilant. In doing so, they can outpace fraudulent activities and minimise losses.

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