Insurance fraud investigations go digital after outbreak of Covid, survey finds

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NEW DELHI: India’s insurance industry has dramatically digitized its fraud investigations in the wake of the covid-19 pandemic, a new survey of industry professionals has revealed. About 68% of respondents said their organizations are using digital solutions for surveys, while 19% said they are at various stages of planning for the digital transition.

The findings are part of a report released on July 23, titled Impact of the Covid-19 pandemic on insurance fraud risk mitigation and investigation.

The qualitative survey of professionals representing major life, health and casualty insurance companies in India was conducted by the Insurance Institute of India (III) with Lancers Network Limited as a knowledge partner, together with the Association of Private Detectives and Investigators India (APDI) and International Anti-Fraud Group (IFTG).

Nearly 60 industry executives representing various risk mitigation functions including claims investigation, priming, pre-issue profile verification, compensation and collection, healthcare reimbursement health and underwriting participated in the survey.

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Deepak Godbole, Secretary General of the Insurance Institute of India, said: “Insurance fraud in the form of inflated or false claims harms not only insurance companies but also their insurance customers or buyers. , who must therefore pay higher premiums. As this survey confirms, the increasing adoption of technologies such as artificial intelligence and data analytics are enabling better and faster insurance investigations, which bodes well for the industry as a whole. “

The survey also found that the industry’s shift to digital fraud investigations is ongoing, with 92% of respondents saying the increased use of technology in investigations will continue in the post-pandemic period. Of these, 71% said they put more emphasis on a digital approach.

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More than one in four respondents (27%) said insurance fraud increased during the pandemic. There has also been an overall increase in investigations of insurance fraud after the onset of covid-19, with 55% of respondents confirming that their anti-fraud-related work activities have either increased overall or increased. in a specific area of ​​operation during the pandemic. However, almost half of those surveyed also reported a budget cut (32%) or zero budget allocation (16%) for surveys.

Shivindra Pratap Singh, Managing Director of Lancer Network Limited, said: “The pandemic since last year has provided fertile ground for an increased incidence of insurance fraud while preventing insurance professionals from do their jobs safely. As the pandemic continues, now is a great time for the fraud and risk mitigation brotherhood of India’s insurance industry to use this disruption as a ‘strategic deadline’ and prepare. for the future by developing their skills and embracing a more inclusive ‘new normal’. ‘.

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The survey also found that around 54% of respondents now prefer virtual classroom training or online learning. Only 24% said they preferred classroom training.

Insurance fraud is usually committed at the time of requests or claims, and is very expensive ??45,000 crore annually to insurance companies. Almost 70% of these frauds are committed through the falsification of documents. According to industry estimates, insurers lose almost 10% of their overall premium collection to fraud.

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