Kathmandu. Artificial intelligence (AI) is transforming the way the insurance industry detects insurance fraud, shifting from a reactive system to predictive and real-time prevention. However, as insurance companies automate the random analysis of claims and insurance policies, the need to balance innovation with confidentiality and ethical accountability is becoming increasingly important.
According to Rupa Malhotra, Head of Customer and Digital at APAC, Zurich Insurance, this transformation represents a major change in the way insurance companies fight fraud. “AI is moving from static rule-based systems to dynamic learning models. Who can identify suspicious behavior as soon as it occurs. ’
By analysing large amounts of structured and unstructured data, from insurance claim forms and invoices to image and geolocation metadata, AI can now detect patterns in these different data forms, Malhotra said. Which were previously invisible to human analysts or legacy systems.
For Ho Sheng Chia, Senior Customer Success Manager at Shift Technologies, adopting AI is about fulfilling a larger societal purpose. “Our aim here is really for the good of society. This is really about protecting the honest insured and ensuring genuine claims are paid quickly and accurately,” he said, adding that keeping premiums affordable and maintaining a sustainable claim loss ratio is critical to the long-term survival of insurance companies. ’
However, both experts agree that the promise of AI depends on trust. Malhotra said, “AI and data privacy have to evolve along with privacy. One cannot move forward responsibly without the other. ‘ Source: Insurance Asia
