November 3, 2020
2:00 p.m. – 3:00 p.m.

Presenters: Charles Watkins, Maria Elena Abate (Colodny Fass), Carl Nemeth (Tower Hill Insurance Group), Mariela Perez-Pennock (Assurant)

When it comes to Artificial Intelligence (AI) and claims handling, it is not a matter of “if”, but rather “when” – and the “when” is yesterday. Understanding and adapting to an AI model which can assist with fraud detection, via a fraud scoring model, can help adjusters and special investigative unit investigators readily detect fraud patterns or red flags from the time the claim is reported. This can lead to a decrease in  cycle time and early identification of issues, thereby assisting with a more focused, expeditious investigation, and a reduction in missed opportunities for SIU involvement.

This presentation will introduce the audience to the construct of Artificial Intelligence and its use in fraud detection, from Point of Sale (POS), to Underwriting and Claims. As with all new concepts and applications, there are legal and ethical issues which emerge and need to be addressed such as privacy rights and data collection.

The presentation will encourage discussion on the pros and cons of adapting AI in the insurance industry, including a dialogue on the effect IoT sensors may have on premiums, the impact of predictive modeling, machine learning, and fraud scoring on claims.

(This is part of the 2020 CLM Focus: Cannabis, Environmental, Insurance Fraud, Property, Subrogation, Claims & Litigation Conference)

For more information, please visit CLM.