For as long as there has been insurance, there has been insurance fraud.
And for as long as there has been insurance fraud, insurance companies have tried to fight it.
From what was once the domain of individuals with gut instincts arose technology solutions designed to help insurance professionals spot a greater number of suspicious claims with greater accuracy. These legacy approaches to technology aided fraud detection often centered on the use of business rules, which have long reigned as the first-line solution for insurers to support their fraud mitigation strategies.
While rules engines can be a helpful tool, their effectiveness tends to diminish over time as fraudsters identify thresholds under which they can pass undetected. As such, the insurance industry has begun adopting artificial intelligence (AI) to build on their use of business rules in an effort to mitigate more fraud, more effectively and more efficiently.
But how did we get here? Let’s look at the evolution of technology use in the fight against insurance fraud.