Zurich strengthens its fraud defences with real-time AI, connecting industry-wide claims data

Zurich Insurance is increasing the power of its real-time fraud detection by becoming the first insurer to partner with Quantexa in the UK.

The new AI-enabled platform will operate across multiple lines of business written by Zurich, alerting claims handlers to suspicious activity using an expanded range of sources and records so they are able to make decisions more effectively.

Zurich has been operating real-time fraud detection for the past three years and detected the equivalent of £260,000 worth of bogus claims every day in 2024¹ but the new approach will highlight connections across an even larger range of variables, and across the whole insurance industry.

The Quantexa Decision Intelligence (DI) platform analyses multiple sources of information including the CUE (Claims and Underwriting Exchange) database, instantly cross-checking details of claims made with other insurers. The platform identifies matches with industry intelligence on the Insurance Fraud Register, connecting automatically rather than relying on manual checks and speeding up the investigation process. The DI software also incorporates open-source corporate data such as Companies House, providing a greater depth of information for AI analysis.

How does it work?

• Claims handlers input details of claims as normal, using information provided online or in a phone call.
• The platform automatically identifies a range of data points such as individuals, addresses, related businesses and even the solicitors connected with the claim.
• It produces a dynamic visualisation of these entities and highlights other claims, policies and any warning flags connected with any part of it.
• The claims handler is shown a guidance rating and risk scenarios, indicating how likely it is the claim could be fraudulent and helping them decide whether to refer it for investigation by the fraud team.
• A clean rating allows faster processing of a claim, ensuring genuine customer claims are processed as quickly as possible.

Scott Clayton, Head of Claims Fraud at Zurich, said:

“The technology and techniques used by fraudsters are always evolving and so are our efforts to stay ahead of them. The adoption of Quantexa means we can detect fraud more effectively than ever, enabling us to take steps to protect our commercial and public sector customers from fabricated and exaggerated claims being made against them. Equally, we always want to protect our honest customers which this enables us to do. Importantly, the real-time nature of the platform means we can reinforce our defences against fraudsters without holding up processes for genuine claimants.”

Dan Higgins, Chief Product Officer at Quantexa, said:

“Effective fraud prevention depends on insurers being able to build up a detailed picture of their customers and all the ways they interact with the industry. Our platform pulls together data which was previously siloed and scattered to give a comprehensive 360-degree view of each claim. We’re delighted to be working with Zurich to put our technology into action in the UK insurance sector for the first time, helping reduce losses from fraud while also increasing the efficiency of other processes.”

• ¹Zurich detected £260,000 worth of bogus insurance claims every day in the last year