Hong Kong insurers bank on technology to detect fraudulent claims in one corner of US$75 billion industry
- The Hong Kong Federation of Insurers will expand its anti-fraud database to include information on critical illness policies
- ICAC arrested four people in September who were part of a syndicate that duped an insurer of HK$26 million between 2017 and 2020
The Hong Kong Federation of Insurers, which represents 138 insurance providers, will expand its Insurance Fraud Prevention Claims Database to cover these policies, relying on artificial intelligence and blockchain technology to detect anomalies.
The database introduced in 2018 currently covers motor vehicle, health and personal accident policies. The system allows its members to upload policy and claims information, personal data and other third party data. The AI analyses the input to arrive at a score of how confident a claim could be fraudulent, and alert members accordingly.
“It is now the time to add critical illness policies to the database in light of the recent scams,” Selina Lau Pui-ling, the federation’s chief executive, said in an interview. About 15 per cent of claims are paid out to fraudsters annually, she added, citing global incidences.
The fraudulent claims involved a similar pattern or modus operandi. The syndicate had arranged for a healthy person to purchase a critical illness policy, and 18 months later used a look-alike cancer patient to undergo medical check-ups and claim for related expenses and compensation under the policies.