Zurich Insurance is enhancing its capabilities in fraud detection by implementing a real-time AI-enabled system in partnership with Quantexa, marking a pioneering move within the UK's insurance sector.
This advanced platform operates across different business areas managed by Zurich, providing claims handlers with alerts on suspicious activities. By utilizing a broader array of data sources and records, the system aims to improve decision-making efficiency.
Real-time fraud detection enhancements
For the past three years, Zurich has successfully deployed real-time fraud detection, intercepting claims amounting to around £260,000 daily in 2024. The updated strategy aims to pinpoint connections among diverse variables and spans the entire insurance landscape. Quantexa’s Decision Intelligence platform plays a crucial role, analyzing data from numerous sources, such as the Claims and Underwriting Exchange (CUE) database, and rapidly cross-referencing claim information with other insurers' records.
This platform also integrates with the Insurance Fraud Register, automating data linkage instead of relying on manual checks, which expedites investigations. Besides proprietary databases, the system leverages open-source data like Companies House to enrich its AI analysis, offering a comprehensive picture for fraud detection.
Operational dynamics
Claims handlers provide claim information through typical channels such as online forms or phone calls
Claims handlers provide claim information through typical channels such as online forms or phone calls. The platform then processes various data points, including people, addresses, related businesses, and even solicitors associated with a claim. It generates a dynamic visualization of these entities, highlighting related claims, policies, and potential warning signs.
Guidance ratings and risk scenarios are presented to assist handlers in determining the fraud likelihood, advising on whether an investigation is necessary. A clean rating means the claim can be processed swiftly, ensuring genuine claims are handled with minimal delays.
Adoption and impact
Scott Clayton, Zurich's Head of Claims Fraud, emphasized the ever-evolving techniques of fraudsters, stressing Zurich's commitment to staying ahead. "The adoption of Quantexa means we can detect fraud more effectively than ever, enabling us to take steps to protect our commercial and public sector customers from fabricated and exaggerated claims," Clayton stated. He noted that the real-time nature of the platform reinforces fraud defenses without hindering genuine claims processes.
Dan Higgins, Quantexa’s Chief Product Officer, remarked on the necessity of a detailed customer profile for effective fraud prevention. He stated, "Our platform pulls together data which was previously siloed and scattered to give a comprehensive 360-degree view of each claim." Higgins expressed enthusiasm about collaborating with Zurich to utilize their technology in the UK insurance sector, enhancing both fraud prevention and procedural efficiency.
Discover how AI, biometrics, and analytics are transforming casino security
Zurich Insurance is increasing the power of its real-time fraud detection by becoming the first insurer to partner with Quantexa in the UK.
The new AI-enabled platform will operate across multiple lines of business written by Zurich, alerting claims handlers to suspicious activity using an expanded range of sources and records so they are able to make decisions more effectively.
Real-time fraud detection
Zurich has been operating real-time fraud detection for the past three years and detected the equivalent of £260,000 worth of bogus claims every day in 20241 but the new approach will highlight connections across an even larger range of variables, and across the whole insurance industry.
The Quantexa Decision Intelligence (DI) platform analyses multiple sources of information, including the CUE (Claims and Underwriting Exchange) database, instantly cross-checking details of claims made with other insurers.
The platform identifies matches with industry intelligence on the Insurance Fraud Register, connecting automatically rather than relying on manual checks and speeding up the investigation process. The DI software also incorporates open-source corporate data such as Companies House, providing a greater depth of information for AI analysis.
How does it work?
- Claims handlers input details of claims as normal, using information provided online or in a phone call.
- The platform automatically identifies a range of data points such as individuals, addresses, related businesses and even the solicitors connected with the claim.
- It produces a dynamic visualization of these entities and highlights other claims, policies and any warning flags connected with any part of it.
- The claims handler is shown a guidance rating and risk scenarios, indicating how likely it is the claim could be fraudulent and helping them decide whether to refer it for investigation by the fraud team.
- A clean rating allows faster processing of a claim, ensuring genuine customer claims are processed as quickly as possible.
Adoption of Quantexa
Scott Clayton, Head of Claims Fraud at Zurich, said: “The technology and techniques used by fraudsters are always evolving and so are our efforts to stay ahead of them. The adoption of Quantexa means we can detect fraud more effectively than ever, enabling us to take steps to protect our commercial and public sector customers from fabricated and exaggerated claims being made against them."
"Equally, we always want to protect our honest customers which this enables us to do. Importantly, the real-time nature of the platform means we can reinforce our defences against fraudsters without holding up processes for genuine claimants.”
Effective fraud prevention
Dan Higgins, Chief Product Officer at Quantexa, said: “Effective fraud prevention depends on insurers being able to build up a detailed picture of their customers and all the ways they interact with the industry. Our platform pulls together data which was previously siloed and scattered to give a comprehensive 360-degree view of each claim."
"We’re delighted to be working with Zurich to put our technology into action in the UK insurance sector for the first time, helping reduce losses from fraud while also increasing the efficiency of other processes.”
