The game is worth the candle: the estimated amount of property and liability fraud is estimated between 2.1 and 2.5 billion euros each year in France by this professional association.
As soon as the contract is signed, artificial intelligence can help detect whether a document has been altered, sometimes by a few pixels, or possible inconsistencies between several documents (identity documents, registration certificates, etc.).
It also allows, for example, to locate photos of collapsed ceilings retrieved from Google images or real photos of windshields adorned with a sticker imitating a broken window sent by unscrupulous policyholders.
“90% of false documents are not detectable with the naked eye”, explains Nadège Faucher, director of controls and the fight against fraud at Allianz France.
These technological tools will also sound the alert if they consider changes to the secret code, changes to bank details for the benefit of a foreign online banking RIB or connections to a customer area from an unusual location to be abnormal.
An identical telephone number for several policyholders, people involved in several claims with different roles “give precise avenues of investigation” on organized gang fraud, adds Eric Sibony, co-founder of Shift Technology, a French unicorn specializing in this area.
Humans take over
At the end of the chain, it is always an employee claims manager who looks in detail at the files set aside by the machine and determines whether there is fraud or not.
A question of law but also of relevance, since “all AI generates false positives”notes Mr. Bizien.
For an insurer, the implementation of new tools to detect fraud results from a trade-off between the cost of development and operation and the savings generated by the detection of false claims which it will not reimburse.
The French branch of the Italian insurer Generali explained last summer that it had saved 20 million euros thanks to the help of Shift Technology.
However, policyholders should not be stigmatized and seen as potential fraudsters, he adds.
The relationship between the insurer and its client is based on trust, adds Mr. Bizien, the insurer rarely sees what it is insuring.
Likewise, the control steps must not slow down the processing of a claim too much, at the risk of annoying the bona fide insured.
