Insurers Employing Technology to Combat Fraud

Insurance fraud remains a costly problem

Host John Weber of AM Best Audio speaks with Brian Wilson, Vice President of the Special Investigations Unit at QBE North America, and Dan Gumpright, Executive Vice President of Product and Operations at DetectSystem. Both experts confirm that fraud touches three to ten percent of claims, adding hundreds of dollars to every family’s annual premium. The discussion opens with a reminder that schemes range from organised crime to everyday “soft” attempts to avoid deductibles.

Fraudsters grow tech savvy, but so do insurers

Gumpright notes how easy it is for anyone to adjust image metadata or download false invoices online. Simple searches on video sites now teach people to doctor photos and documents. Wilson adds that QBE sees repeated use of web images and invoice templates, even crude photo edits, yet many claimants remain unaware that such tampering leaves a digital trail.

FDS runs one hundred twenty checks per file

DetectSystem’s File Detection Suite screens every attachment at first notice of loss. It reviews metadata, compares pixel patterns, and checks documents against known templates. QBE has integrated the tool into its claim workflow, allowing a bot to process each image or PDF in seconds rather than assigning skilled examiners to manual reviews that once took hours.

Real-world catches highlight the value

Wilson shares a water damage claim where photos of a washing machine, lifted from a home-improvement website, were flagged instantly. Cropped edges and colour mismatches exposed the forgery. Another case involved a claimant who altered the time and date on a phone yet forgot that FDS keeps a firmware release library, revealing that the device software did not exist on the stated date.

Starting an AI anti-fraud journey

The guests advise insurers to begin with a thorough self assessment: map claim types, identify fraud threats, and spot documents that lack independent verification. From there, design a focused pilot to measure impact. QBE’s experience shows that automating forensic checks lets staff approve legitimate claims more quickly while isolating only those that merit deeper investigation.

Key takeaway

Automated file forensics powered by AI gives carriers a practical line of defence at attachment level. By checking every image and document at intake, insurers protect honest policyholders, reduce loss costs, and keep pace with ever evolving manipulation tactics.

Listen to the entire podcast episode here.