Wednesday, August 7, 2019, 11:47 AM
ICICI Lombard using AI for fraud detection
Private sector insurer ICICI Lombard is using artificial intelligence (AI) and machine learning to not only improve claims processing and settlement but also to detect frauds in segments such as motor and health insurance. “We use machine learning to figure out when the surveyor is assessing motor claims to see which parts are outliers. Auto parts are priced differently across the country, but in case some garage charges very high, the algorithm can throw it up. It shows anything which is 5% too high or too low as an outlier,” Girish Nayak, Chief of Customer Service, Operations and Technology said. Similarly, in the case of medical claims, the insurer is using machine learning AI to check if a hospital may be sending claims for a particular illness at a particular price. “In such cases, you know there is something wrong and you send someone to check it. This can increase efficiency and help detect frauds better,” Nayak said.
