The Canadian Life and Health Insurance Association (CLHIA) announced the launch of the industry initiative to pool claims data and use advanced artificial intelligence (AI) tools to enhance efforts to investigate benefits fraud. Shift Technology has been chosen to help the industry analyze claims data to better detect, investigate and prosecute 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,” the CLHIA states.
It adds that it expects the initiative will expand in scope over the coming years to include more data over time.
“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,” says CLHIA’s president and CEO, Stephen Frank.
