Life and health insurers to use advanced artificial intelligence to reduce benefits fraud

TORONTO, Feb. 14, 2022 /CNW/ - The Canadian Life and Health Insurance Association (CLHIA) is pleased to announce the launch of an industry initiative to pool claims data and use advanced artificial intelligence tools to enhance the detection and investigation of benefits fraud.

Every insurer in Canada has their own internal analytics to detect fraud within their book of business. This new initiative, led by the CLHIA and its technology provider Shift Technology will deploy advanced AI to analyze industry-wide anonymized claim data. By identifying patterns across millions of records, the program is enhancing the effectiveness of benefits fraud investigations across the industry.

We expect that the initiative will expand in scope over the coming years to include even more industry data.

"Fraudsters are taking increasingly sophisticated steps to avoid detection," said Stephen Frank, CLHIA's President and CEO. "This technology will give insurers the edge they need to identify patterns and connect the dots across a huge pool of claims data over time, leading to more investigations and prosecutions."

"The capability for individual insurers to identify potential fraud has already proven incredibly beneficial," explained Jeremy Jawish, CEO and co-founder of Shift Technology. "Through the work Shift Technology is doing with the CLHIA, we are expanding that benefit across all member organizations, and providing a valuable fraud fighting solution to the industry at large."

Insurers paid out nearly $27 billion in supplementary health claims in 2020. Employers and insurers lose what is estimated to be millions of dollars each year to fraudulent group health benefits claims. The costs of fraud are felt by insurers, employers and employees and put the sustainability of group benefits plans at risk.

About CLHIA
The CLHIA is a voluntary association whose member companies account for 99 per cent of Canada's life and health insurance business. These insurers provide financial security products including life insurance, annuities (including RRSPs, RRIFs and pensions) and supplementary health insurance to over 29 million Canadians. They hold over $1 trillion in assets in Canada and employ more than 158,000 Canadians. For more information, visit www.clhia.ca.

About Shift Technology
Shift Technology delivers the only AI-native decision automation and optimization solutions built specifically for the global insurance industry. Addressing several critical processes across the insurance policy lifecycle, the Shift Insurance Suite helps insurers achieve faster, more accurate claims and policy resolutions. Shift has analyzed billions of insurance transactions to date and was presented Frost & Sullivan's 2020 Global Claims Solutions for Insurance Market Leadership Award. For more information, visit www.shift-technology.com.

SOURCE Canadian Life and Health Insurance Association Inc.

Kevin Dorse, Assistant Vice President, Strategic Communications and Public Affairs, CLHIA, [phone], [email protected]; Rob Morton, Corporate Communications, Shift Technology, 617-416-9216, [email protected]