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

TORONTO, February 14, 2022 /CNW/ – The Canadian Life and Health Insurance Association (CLHIA) is pleased to announce the launch of an industry initiative to consolidate claims data and utilize advanced intelligence tools to improve the detection and investigation of benefits fraud.

Each insurer of Canada has its own internal analyzes to detect fraud in its volume of business. This new initiative,edited by CLHIA and its technology provider Shift Technology will deploy advanced artificial intelligence to analyze industry-wide anonymized claim data. By identifying patterns among millions of records, the program improves the effectiveness of benefits fraud investigations across the industry.

We expect the initiative to expand its scope over the next few years to include even more industry data.

“Fraudsters are taking increasingly sophisticated measures to avoid detection,” said Stephane Frank, President and CEO of CLHIA. “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 lawsuits.”

“The ability of individual insurers to identify potential fraud has already proven to be incredibly beneficial,” explained Jeremy Jawish, CEO and co-founder of Shift Technology. “Through the work Shift Technology is doing with CLHIA, we are extending this benefit to all member organizations and providing a valuable anti-fraud solution to the entire industry.”

Insurers reimbursed almost $27 billion claims for supplemental health benefits in 2020. Employers and insurers lose what is estimated to be millions of dollars each year due to fraudulent group health claims. The costs of fraud are felt by insurers, employers and employees and jeopardize the sustainability of group benefit plans.

About CLHIA
CLHIA is a voluntary association whose member companies represent 99 percent of from Canada life and health insurance business. These insurers provide financial security products, including life insurance, annuities (including RRSPs, RRIFs and pension plans) and supplemental health insurance to more than 29 million Canadians. They retain $1 trillion of assets in Canada and employ more than 158,000 Canadians. For more information, visit www.clhia.ca.

About Shift Technology
Shift Technology provides the only AI-native decision automation and optimization solutions designed specifically for the global insurance industry. Addressing several critical processes throughout the insurance policy lifecycle, Shift Insurance Suite helps insurers resolve claims and policies faster and more accurately. Shift has analyzed billions of insurance transactions to date and received the 2020 Global Claims Solutions for Insurance Market Leadership Award from Frost & Sullivan. For more information, visit www.shift-technology.com.

SOURCE Canadian Life and Health Insurance Association Inc.

For further information: Kevin Dorse, Assistant Vice President, Strategic Communications and Public Affairs, CLHIA, (613) 691-6001, [email protected]; Rob Morton, Corporate Communications, Shift Technology, 617-416-9216, [email protected]

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