Founded in December 1996 with the ambition of becoming a key player in the personal insurance market, Génération is part of the Adelaide Group, a family-owned, independent European group specialising in insurance consultancy, intermediation, distribution and services. Although its initial core business was group insurance, the company recently broadened its scope by launching an individual business three years ago. Today, with a team of 1,200 employees, spread over four management sites in France and Portugal, Génération provides cover for more than 2.3 million people. The diversification of Génération's business, combined with sustained growth, has over the years made the broker a partner of choice in the field of group insurance.
"As a broker manager, Génération plays a crucial role in risk management, without being the risk bearer," explains Gilles Le Vavasseur, Director of Risk Bearer Relations and New Markets - which includes compliance issues - at Génération. "Our role is to support insurers in their day-to-day missions, and to help them meet the challenges they face. In particular, the fight against fraud, which has become a major issue in recent years.”
With the aim of setting itself apart from its competitors, this specialist customer service broker, which is also driven by a sincere desire to contribute to the development of the sector, has decided to make Shift's AI available to its customers. This will help them to combat fraud, abuse and wrongful payments more effectively, and help them to control their expenditure so that, ultimately, they can guarantee their policyholders an impeccable customer service.
"It all started in 2020. We looked at the solutions available on the market, and it quickly became clear to us that Shift was the player best placed to meet our needs. In other words, to help us support the risk carriers in our portfolio towards a more modern and technological approach to risk and compliance management," explains Gilles Le Vavasseur. "However, it wasn't possible to implement the solution immediately: we first had to convince some of them to dare to embrace innovation in an activity as vital as the fight against fraud.”
The implementation of the detection product, Shift Fraud Waste and Abuse Detection, finally took place in April 2021. The scope of the collaboration between the two companies was subsequently extended to the detection of document fraud, and then to Long-Term Conditions (ALD) in 2023, in particular with a view to monitoring the proper application of the hospital billing rules in each case. Today, Génération's compliance team is made up of around ten people, half of whom work on fraud detection, "in addition to the various business correspondents: because fraud is everyone's business within the company, and everyone makes their contribution", as Gilles Le Vavasseur explains.
Shift Technology's artificial intelligence-based solutions have enabled the brokerage to move from a very pragmatic approach to a powerful and agile tool, both in terms of a post-payment control, i.e. after reimbursement to policyholders, and a pre-payment control, i.e. before payment to policyholders. The first significant impact was seen in the field of hospitalisation, where Shift paid particular attention. In addition to making a significant positive ROI, the document fraud detection tool has made it possible to find other types of fraud, such as network fraud, which would previously have gone undetected. At the beginning of 2024, savings had doubled over the previous twelve months thanks to Shift's solutions and Génération's investigation teams. Grouping certain cases of fraud by pooling non-personal data, or "pooled detection", is also proving to be an interesting tool for the brokerage company.
"The last three years of collaboration with Shift have enabled us to make a series of strategic adjustments with a view to further increasing the future return on our investment in Shift Technology's solutions. Now that this essential phase has been completed, we can look to the future with confidence. I am firmly convinced that the use of AI to combat fraud in the health and protection insurance sector is an essential element for the future of risk carriers," concludes Gilles Le Vavasseur, Director of Risk Carrier Relations and New Markets and Head of Compliance at Génération.
"I am firmly convinced that the use of AI to combat fraud in the health and provident insurance sector is an essential element for the future of risk carriers."
- Gilles Le Vavasseur, Head of Risk Carrier Relations and New Markets