Tech Gains Tractionin Fight Against Insurance Fraud


Max Dorfman, Research Writer, Triple-I

According to the report, insurance fraud costs $308.6 billion annually. Recent research By the Coalition against Insurance Fraud (CAIF). And while staffing within insurers’ Special Investigation Units (SIUs) is an issue, CAIF has found an increase in the use of anti-fraud techniques.

CAIF notes that the insurance products that have been hit hardest are:

  • Life insurance is $74.7 billion a year.
  • Medicare and Medicaid $68.7 billion.When
  • Property and casualties, $45 billion.

“Every year there is a huge and monumental impact that insurance fraud has on American citizens, American families and our economy.” Matthew Smith saidSecretary General of the Union.

another Recent CAIF Studies We examined the response of SIU and insurance companies to fraud. According to the study, SIU staff said he had increased 1.4% from 2021 to 2022, slower than his 2.5% increase in his two previous studies that addressed the issue. I understand. One of the top concerns of anti-fraud leaders surveyed by CAIF is staffing and talent.

However, additional CAIF study found that anti-fraud techniques are being used more and more. This is a positive sign in the fight against these crimes. One of the key findings of that report is that 80% of respondents use predictive modeling to detect fraud, up from 55% of them in 2018.

Insurance fraud is not a victimless crime. According to the FBI, the average American family spends extra money. Premiums from $400 to $700 Every year because of fraud. Most of these costs stem from common scams, such as inflating the actual bill. Misrepresenting facts regarding insurance claims. Submit a claim for injury or damage that never occurred. and production accidents.

To further combat insurance fraud, there are ways to file a complaint, such as contacting your state fraud agency. Contact your insurance company to see if they have a fraud system in place.Using the National Insurance and Crime Bureau (NICB) “Report abuse” button; and report it to the local FBI branch.

“Insurance fraud is a crime we all pay for,” added CAIF’s Smith. “Ultimately, it is American policyholders and consumers who pay the high price of insurance fraud.”


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