Modern Insurance Magazine Issue 66

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Digital Media Forensics Detecting image and document fraud early and accelerating claim processing. • Exposes pixel manipulation • Finds metadata inconsistencies • Identify images reused or copied from online • Early fraud detection • Efficient claims process Get in touch to arrange your demonstration ClaimsUK@verisk.com
THE FRAUD BOARD WHAT’S IN A NAME? Data is our lifeblood, but people remain our superpower. Is that really understood in this modern, digital, tech-obsessed world of insurance fraud? Name: A four-letter word just to get me along Ting Ting’s singer Katie White once explained that the meaning of their 2008 hit song “That’s Not My Name” was frequently misunderstood, with its lyrics actually based on their early experiences of being overlooked and made to feel insignificant. This was perhaps the status of many insurance fraud teams some years ago. Thankfully, tackling fraud is now very much an integral part of modern insurance operations. Indeed, the very best operators ensure that counter-fraud capability is firmly embedded, continuously invested in, tackled across the acquisition, servicing and claim lifecycle, and appreciated as a net profit centre and way of protecting revenue. But in a business world that is characterised by the increasing reliance on data, technology and AI, will the role and perceived value of the investigator diminish? A skillset that’s tricky to capture I think we’ve all drafted enough job profile templates to appreciate the challenge of capturing the multi-faceted skillset of an ‘investigator’. If we think about it, the demands of this role are hugely varied, especially in the world of countering insurance fraud. As an inquisitor, they possess the ability to raise the right question, at the right time and in the right way to move an investigation along. They act as a manager, directing and coordinating resources internally and externally to their organisation. They work as a data analyst, with an ever-increasing need to seek out, manipulate and interpret data frequently drawn from multiple information sources and systems. Investigators need to be confident communicators, enabling collaboration across both internal teams and external partners, together with an empathic ear for victims of crime. Plus, they must perform as a key decision-making authority, exercising responsibility for making critical calls throughout the investigation lifecycle; from determining avenues of investigation to managing budgets, instructing colleagues and suppliers, and ultimately making that crucial call on whether there’s evidence of fraud and action to be taken. What’s in a name? Data remains our essence. Technology is our increasingly vital support system, and AI is emerging as a crucial companion decision maker. However, people remain our superpower. A human investigator will always be needed; whether that’s to develop the tools, interpret the results, or decide and exercise accountability for the critical action. What’s in a name? Quite a lot, actually. Matt Gilham, Director, Whitelk THE AI BOOM: THREAT, OR FRIEND? It’s easy to listen to the scuttlebutt around the coffee machine that the rise of AI is bringing a dystopian future, threatening to the role of the counter fraud professional. At FRISS, we have long focused on making our technology a help and aide for the Underwriter, Claims Handler or Investigator. The rapid emergence and adoption of Generative AI and the use cases it can help with may seem like the death knell for many jobs, but that doesn’t have to be the case. We hold the view that the best counter fraud defences are those that make use of both the technology and the knowledge, experience and insight of the professional underwriter, adjuster or investigator. If we look at the forthcoming legislation around the use of AI, best practice guidelines and codes of conduct that are being published in this space, there is one clear pointer - that automating a decision based solely on AI is not a good idea. It is not enough for the human to be a tick box in the process; the Government and regulator expect the human element to be meaningful. If we look at current processes, it’s clear that the decision to come off cover, repudiate a claim or escalate to law enforcement for prosecution requires multiple levels of sign off. It’s our opinion that this shouldn’t change. The use of AI models as indicators of potentially fraudulent behaviour is widespread, and there are interesting new use cases in GenAI and Large Language Models (LLMs) which help us understand and use information more quickly. Harvesting and synthesising open-source data on commercial risks is fairly common. With GenAI, there’s now the added capability to put the harvested information in context, leading to better understanding of risk and verification of facts, avoiding potential non-disclosure or misrepresentation. AI also presents unmatched opportunities for fraud detection and prevention. By intelligently utilising AI automation and Generative AI, insurers can improve their fraud detection capabilities while safeguarding consumer data. This proactive strategy ensures resilience against evolving fraud tactics. The Counter Fraud team will be enabled to handle more cases than ever before. Far from a threat to jobs, the AI revolution will be a boon to the average Counter Fraud team. It will need to be, as the fraudsters are on the other side of the technology… without the restraint. Martyn Griffiths, Sales Manager UKISA, FRISS MODERN INSURANCE | 47
Page 1 and 2: ISSUE 66 ISSN 2515-3803 THE ART OF
Page 3 and 4: WELCOME Hello readers! A very warm
Page 5 and 6: 8 12 14 17 29 41 36 38 51 53 55 Ins
Page 7 and 8: LV= GENERAL INSURANCE The Value of
Page 9 and 10: GRAPH 1: Online quiz to identify po
Page 11 and 12: INSIGHT Holistic discount systems F
Page 13 and 14: While advancements in artificial in
Page 15 and 16: INTERVIEWS Europcar is investing he
Page 17: EDITORIAL BOARD The Importance of T
Page 20 and 21: The Power of Data At LexisNexis ®
Page 23 and 24: EDITORIAL BOARD Combining Data with
Page 25: EDITORIAL BOARD The Building Blocks
Page 28 and 29: UK’S LARGEST CROSS-SECTOR CUSTOME
Page 30 and 31: TRIAGEPLUS Customer digital experie
Page 32 and 33: Straightforward insurance technolog
Page 35 and 36: Dr Thomas Matthew Hudd Connell Titl
Page 37 and 38: Prioritise work-life integration: B
Page 39 and 40: implementation work (as your provid
Page 41 and 42: THE FRAUD BOARD The theme of ‘peo
Page 43 and 44: THE FRAUD BOARD FREQUENTLY ASKED QU
Page 45: THE FRAUD BOARD THE HUMAN TOUCH: WH
Page 49 and 50: THE FRAUD BOARD IASIU: EDUCATION, A
Page 51 and 52: Modern Insurance Magazine sits down
Page 53: MANAGING EXPECTATIONS AMIDST CUT-BA
Page 56 and 57: CELEBRATING EXCELLENCE IN THE GLOBA
Page 58 and 59: INSURTECH WELCOME Greetings, and we
Page 60 and 61: INSURTECH SAS We Q Franklin, it was
Page 62 and 63: INSURTECH InnSure QCharlie, InnSure
Page 64 and 65: INSURTECH The Geneva Association QM
Page 67 and 68: INSURTECH EDITORIAL BOARD WELCOME t
Page 69: Ohio: The Heart of Industry Transfo
Page 73 and 74: INSURTECH Guardians of our Customer
Page 75 and 76: Are your existing systems holding y

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