Use of AI to Fight Insurance Fraud Hits All-Time High

AI and healthcare

Insurers’ use of predictive analytics to fight fraud has reached an all-time high, according to an insurance fraud technology study by the Coalition Against Insurance Fraud and SAS. The study reveals that 80% of insurers use predictive modeling to detect fraud, up from 55% in 2018. In a category new to the 2021 survey, the… Continue reading Use of AI to Fight Insurance Fraud Hits All-Time High

Insurers Using RICO Act to Strike Back Against Alleged Fraud

Consumer fraud, scams

Fed up with what they claim is deliberate claims fraud that is triggering skyrocketing costs — and ever-higher premiums for consumers — two Florida insurance companies have gone on the offensive against alleged fraudsters using a legal tool developed to help federal prosecutors fight organized crime. Lawsuits by Citizens Property Insurance Corp. and Heritage Property… Continue reading Insurers Using RICO Act to Strike Back Against Alleged Fraud

Zurich Partners with Carpe Data to Combat Fraud and Increase Claims Efficiency through New Data

Health Insurance fraud and NBA players

Zurich has found a new ally in the fight against increasing claims costs. The insurer is now working with Carpe Data, a California-based company whose innovative use of alternative and emerging data provides Zurich with improved claims processing efficiency and a major advantage in fighting fraud. Carpe Data’s innovative claims monitoring solution ‘ClaimsX’ gives Zurich… Continue reading Zurich Partners with Carpe Data to Combat Fraud and Increase Claims Efficiency through New Data

Tanker Owner Set Fire to Ship for $77 Million in Insurance, Court Says

American Club insuring Iran oil

A Greek shipowner was behind an elaborate fraud plan in 2011 to set fire to his own tanker off the coast of Yemen to collect $77 million in insurance, according to a High Court judge in London. Judge Nigel Teare said Marios Iliopoulos, who is now the chief executive of Greek ferry company Seajets, coaxed… Continue reading Tanker Owner Set Fire to Ship for $77 Million in Insurance, Court Says

A Senator Questioned Why Insurance Companies Are Paying Police to Investigate their Customers

A senator responsible for overseeing the insurance industry spoke out Friday about State Farm, Farmers, and other major insurers funding police and prosecutors to investigate fraud — creating a system that can ensnare innocent people. “Insurance companies should not be permitted to abuse their investigations processes,” said Sen. Chris Van Hollen of Maryland, the top… Continue reading A Senator Questioned Why Insurance Companies Are Paying Police to Investigate their Customers

$600K Miami-Dade Home Insurance Fraud Scheme Dismantled, Officials Say

An insurance fraud scheme in Miami-Dade – the type of scam that leads to increased insurance premiums for all consumers – has been dismantled, according to officials. Nine people have been arrested over the $600,000 Miami-Dade homeowners insurance fraud scheme. The arrests were the result of a year-long fraud investigation named “Operation Rubicon.” “Arrests include… Continue reading $600K Miami-Dade Home Insurance Fraud Scheme Dismantled, Officials Say

Shift Technology Raises $60 Million to Detect Insurance Fraud

Paris-based Shift Technology has raised another $60 million funding round. Bessemer Venture Partners is leading the round and existing investors Accel, General Catalyst, Iris Capital and Elaia Partners are also participating. Shift Technology is all about detecting fraudulent insurance claims. There are 70 insurance companies around the world relying on its product, such as MACIF… Continue reading Shift Technology Raises $60 Million to Detect Insurance Fraud

SEC Charges Former Insurance Wunderkind with Fraud

SEC Sues Coinbase

The Securities and Exchange Commission charged a former insurance industry wunderkind with fraud, claiming he and an associate diverted more than $300 million from insurers they controlled and caused the companies to become insolvent. The civil charges against Alexander Chatfield Burns, now 31 years old, include allegations that he and the associate “raided those insurance… Continue reading SEC Charges Former Insurance Wunderkind with Fraud