Insurance fraud has plagued the industry for several decades. According to estimates, fraud accounts for up to 10% of all claim expenditure in Europe, leading to substantial losses for both insurers and their customers, as the unwarranted costs translate into higher premiums. Our client–one of the main insurance providers in Poland–has also experienced the adverse effects of this issue and sought ways to increase fraud detection levels in its range of transportation insurance packages. When they approached us, certain flaws in their existing system were leading to additional, unjustified costs, but also substantially extending the time needed to process documents related to loss adjustment.

Upon analysing our client’s systems, we proposed a new approach to the process of handling claims and related loss adjustment documents. Our team delivered a custom AI- and ML-driven solution helping to assess whether a given claim should qualify as potentially fraudulent.

Implementation of the custom-built solution has immediately improved the efficiency of fraud claim detection. The company can now better assess which cases should be further analysed, and the proportion of claims identified as fraudulent has also increased. As a result, our client has significantly reduced costs associated with the processing and payout of fraud claims.