“Adapting Claim Investigations for AI-Driven Fraud”
Swift Currie attorney Kayla McCallum authored an article for Claims Journal discussing how AI-driven fraud is on the rise and steps professionals should take to reduce risk and identify fraud.
Artificial intelligence allows claimants and organized rings to now easily create and produce fraudulent AI-generated photographs, invoices, medical records and entire identities that can pass an initial review without difficulty.
McCallum suggested that enhancing the document review process and conducting in-person inspections, interviews, and examinations could help identify potential instances of AI-driven fraud. However, claims professionals have good faith obligations, and denials must be supported by reasonable and though investigation, not simple suspicion of AI use.
“It is imperative for professionals to stay vigilant as each new trend emerges,” said McCallum. “Continue to test and verify documents and take the claims investigation from behind the desk and into the field.”
To view the full article, you may click here.
