The headline caught my eye linking  "Ecclesiastical"  - relating to the Christian Church or its clergy with fraudulent claims before rational thought kicked as it refers to the insurer of many churches and cathedrals rather than the religious life.  

Fraud is a fact of life and the pressures of inflation and the cost of living, the flatlining economy, and increasing uncertainty about the future can only add to the motivation to over-egg a claim or even make false ones.

"Ecclesiastical Insurance’s claims team detected over 130 cases of fraudulent activity during 2022, all of which were proven false following investigation. By investigating the claims and following up with legal proceedings where necessary, the specialist insurer said it was able to save over £1.3m in casualty claims and over £1.5m in property claims".

Isobel Rafferty Insurance Times 7th February, 2023

That's without considering professional fraud. Organised crime is as able to use technology as much as any insurer to hide its fraud behind carefully constructed digital barriers. This is where the experience of seasoned fraud investigators can sniff out suspicious trends and claims. But as fraud cases increase it becomes harder.

Technology can augment the human intuition and knowledge of claims handlers and fraud investigation teams. Not least surfacing the incredible amount ( 80% plus) of unstructured text that is part and parcel of all insurance claims e.g. free text entries in claims evidence. 

Even digital claims platforms cannot handle this unless the data can be surfaced, normalised, and analysed into meaningful insights for the right decisions to be made by insurers. Software like that from Sprout.ai, Omn:ius and 360Retrieve all address the issue in different ways. Some leveraging AI, and some not.

Digital claims platforms like RightIndem can analyse metadata in photos and videos and flag inconsistencies eg in dates and locations compared with the submitted claims information. Not to mention detect doctored images.

Then you have the data sources and counter-fraud software like Synectics and Shift, Friss and Quantexa. When integrated into a technology ecosystem these give the protection in depth to counter opportunistic and professional fraud.

Technology will never be a complete counter-fraud solution, however. Professional investigators whether inside the insurer or specialists like Robertson and Company in the UK are a vital part of the counter-fraud strategy. Augmented with technology.

And a modern, micro-services architected, API-rich, cloud-native digital claims platform that can support the ecosystem of technology and people needed to counter fraud effectively.