AI fraud detection and claims in insurance

in partnership with
Digital Reinvention
30/06/2025 Study
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AI is reshaping the insurance industry, especially in fraud detection and claims processing. This whitepaper explores how insurers are moving from slow, manual workflows to fast, intelligent systems powered by machine learning, computer vision and generative AI.

From automating claim intake and verifying documents to detecting fraud in real time and interpreting complex policy terms, AI is helping insurers settle claims faster, more accurately, and with greater transparency. GenAI is even transforming customer interactions, offering instant clarity on coverage and eligibility.

Real-world case studies show dramatic results: up to 77% fraud detection accuracy, 70% faster claims processing, and 30% cost reductions. As AI evolves from automation to proactive risk mitigation, it’s clear that insurers who invest early will lead the way in efficiency, trust, and innovation.

KEY INSIGHTS

AI Driving Claims Transformation

Insurers are using AI, ML, and generative AI to automate claims intake, assess damage, verify documents and support decision-making—delivering faster, more transparent, and customer-friendly experiences.

Challenges to Overcome

Legacy systems, fragmented data, and limited AI literacy are major obstacles. Many insurers also struggle to scale pilot projects while ensuring regulatory compliance and ethical AI use.

Looking Ahead

To fully realize AI’s potential, insurers must modernize their infrastructure, break down data silos, and focus on high-impact use cases—turning claims and fraud management into a competitive advantage.

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