Insurance fraud can be committed by either the buyer or the seller of an insurance policy.
The seller may offer policies from non-existent companies, fail to submit premiums, and churn policies to create more commissions. The buyer exaggerate claims, falsify medical history, post-date policies, sell their policy to for cash when they are diagnosed with a terminal disease, or fake their death or kidnapping. We will focus on the buyer insurance fraud in this post.
Insurance claims management is the process of managing a claim from reception to settlement. The insurance claim process is particularly suited to machine learning solutions as much can be done to cut time and costs, leading to speedier resolution of claims to the satisfaction of both insurer and insured.
Life insurance underwriting is the act of accepting liability under a life insurance policy. Insurers increasingly use machine learning to identify risk categories and recommend policies, faster and more accurately than humans alone.
In these times of lockdowns, these programs become especially important as people are more interested in life insurance but may only be reached remotely.
Banks, credit unions, credit card companies, insurance companies, stock brokerages, investment funds, and more must report their activities to government regulatory agencies. Following financial crises in the late 2000s, regulatory compliance has become stricter and more onerous on financial services companies like those listed above.
From the stricter need for reporting and the massive amounts of data generated by financial institutions, the regtech industry has sprung up, combining regulatory reporting and big data technology.