Guide to Fighting Insurance Fraud Post-Pandemic

2020-2021 jumpstarted the insurance’s entry into the digital age in Asia with ground-breaking changes, including unprecedented digitalisation and rapidly evolving customer expectations. However, even as insurers rise to the challenge of limited close-contact engagement with clients, it has also introduced faced new challenges including a rise in fraudulent behaviour.

Asia-Pacific accounts for the highest percentage of the estimated US$1 billion insurance claim fraud. The lack of time, resources, and scale to combat the problem may mean continued losses.

Reflecting on the impact of COVID-19 on his team’s work, Larry Ryan, Vice President, Group Re Claims and Treaty Development at Reinsurance Group of America said: “We’re just scratching the surface of the ways we can apply digitization and analytics to fraud detection, and the pandemic accelerated this evolution.”

With delays in access to medical records coinciding with increased volumes of claims, “Insurers are changing claims investigation and documentation standards, creating a prime environment for fraud. The most frustrating part is that the information we need almost certainly exists in an electronic health record somewhere – healthcare providers record everything so they can bill for it. The Holy Grail of claims adjudication is establishing systems to access electronic health records.” said Ryan.

FutureCIO, in partnership with SAS, invites you to an unconventional webinar to tackle some of the most critical challenges insurance firms and healthcare providers in Asia will face amid an accelerating mutation of the pandemic and hospitals in some ASEAN countries already feeling a repeat of 2020-2021. We will cover:

• The evolution of insurance fraud schemes during the pandemic
• Identify some of the impacts that have been felt by insurance carriers
• How to protect against these new forms of fraud