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General Insurers Collaborate To Fight Fraud

Nearly 15% of health and motor insurance claims are fraud. GIC has roped in LexisNexis to use data analytics for combating fraud claims

  • 17 Jan 2018
  • 2 min read

Around 10-15% of the claims settled in terms of motor and health insurance are frauds. This has led general insurance companies to come together and identify the breeding grounds and patterns of frauds. To this effect, the association of non-life insurers, known as General Insurance Council (GIC) has hired the services of US-based data analytics firm LexisNexis Risk Solutions.

The data analytics firm is doing a study that will take into consideration the premium and claims data of policyholders, and also other stakeholders such as motor garages, diagnostics, pharmacies, laboratories and hospitals. This study is a pilot project that entails insurers submitting their last two year’s data pertaining to health and motor insurance policies, along with claims.

So far, 10 insurance companies have submitted data. The first set of data comprises of 75 million motor insurance policies, 10 million health insurance policies and 8 million motor insurance claims. The fraud study aims to identify fraud cases based on 100 data elements.

Giving more details on the initiative, R Chandrasekaran, secretary general of GIC said that they are using a two-pronged approach to combat frauds. They have created a fraud risk-mitigation portal for all insurers, in which each member is required to enter identified and suspected cases of fraud.

The portal has categorized fraudsters as insured individuals, agents, surveyors, garages and hospitals among others. So far, this information sharing from insurers has helped insurers identify some fraudsters, with 15,000 cases reported annually.


Also Read:

55% Households In India Don’t Seek Healthcare From Public Sector, Says Survey
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