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CONCLUSION
AI is really becoming table stakes in the insurance industry when
it comes to fraud prevention and investigation. However, it is no
longer good enough just to say that we're using AI: it's imperative
to pay heed to transparency and explainability in the use of AI,
fairness, and most certainly, accountability.
The bottom line is: AI for insurance fraud cannot be a " black box "
technology, where only results matter and the internal workings
of the system aren't viewed as important.
In summary, we see the pace of change continuing to
accelerate. Autonomous technology will play a key role in
helping insurers combat fraud.
One final note: Humans who are tasked with fighting insurance
fraud are not going to be replaced by AI, but investigators who
fail to use artificial intelligence will be replaced. The world
isn't in a place where insurance fraud investigators could turn
100% of decisions over to machines. So, having human experts
who have been trained in making fair decisions, accompanied
by a technology system that provides contextual guidance,
is the way forward for the insurance industry and AI. The
human is absolutely not replaceable, since they are the final
" safety valve " in ensuring that AI technology is not working
at cross-purposes.
It is an exciting and challenging time to work in the insurance
industry as it has always been!
Gary Saarenvirta is Daisy Intelligence's founder and CEO and a preeminent
authority on artificial intelligence. The former head of IBM Canada's data
mining and data warehousing practices, Gary is passionate about AI and its
ability to transform how insurers grow their businesses and establish an edge
in an increasingly challenging environment. Under Gary's leadership, Daisy has
established a track record of delivering verifiable financial outcomes for a rapidly
growing list of clients.
Sources
1) This figure includes all lines of insurance. https://www.nj.gov/oag/
newsreleases18/pr20181009a.html
2) The Colorado bill can be found at https://leg.colorado.gov/sites/default/files/
documents/2021A/bills/2021a_169_01.pdf. Track its status here, https://leg.
colorado.gov/bills/sb21-169/
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https://www.nj.gov/oag/newsreleases18/pr20181009a.html https://www.nj.gov/oag/newsreleases18/pr20181009a.html https://leg.colorado.gov/sites/default/files/documents/2021A/bills/2021a_169_01.pdf https://leg.colorado.gov/sites/default/files/documents/2021A/bills/2021a_169_01.pdf https://leg.colorado.gov/bills/sb21-169/ https://leg.colorado.gov/bills/sb21-169/

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