Page 30 - The Insurance Times March 2025

vestigators results in misalignment in gathering crucial vestigators, face match and ID verification, intelligent
data and high turnaround time (TAT) data enrichment, and auto-report generation.
iv. Data consolidation challenges: Historic case data of- iv. Efficient Vendor Collaboration: Centralizes vendor in-
ten resides in disparate, siloed systems that lack inte- teractions, providing tools for case assignment,
gration, leading to gaps in the ability to track and moni- workflow management, and reports with real-time
tor recurring fraudulent behaviors over time. updates and performance tracking.
v. Privacy-aware Data Management: Implements robust
v. Lack of data-privacy: Current processes inevitably ex-
pose sensitive policyholder and investigation data to un- encryption, access control, and compliance mechanisms
authorized access, increasing the risk of misuse, legal to safeguard sensitive policyholder information and in-
penalties, and loss of customer trust. vestigation data from unauthorized access and misuse.

The result? Enhanced accuracy, fewer errors, and a 3x boost
These manual investigation workflows and outdated prac-
in field operation productivity. The platform helps insurers
tices are creating a perfect storm for inefficiency and mis-
resolve cases faster during pre-issuance and claims, reduc-
takes. These gaps in the system not only slow things down ing average investigation time by at least 25%.. It saves
but also give fraudsters the opportunity to exploit weak- investigators over 12 hours per week on manual data entry
nesses. It is clear that the industry urgently needs smarter, and reporting, allowing them to focus on detailed investi-
more efficient investigation systems to close these gaps, gations and cross-checks.. This not just helps FCUs to get
reduce errors, and keep pace with evolving fraud tactics. more investigations done faster but it also proves beneficial
for genuine customers who enjoy an 80% reduction in re-
Leveraging AI and Automation for Inves- jections due to enhanced data integrity and robust docu-
tigation Efficiency mentation that supports underwriting and claims decisions.

In the quest for a more efficient and comprehensive system, it Unlock Efficient Fraud Control with AI-
is widely recognized that AI-assisted technological transforma-
tion is needed to overcome the challenges in fraud control. powered Insurance Investigations
Artificial intelligence has already had a significant impact on Minimizing risk, especially through preventing frauds, is cru-
various sectors, and its potential in insurance fraud detection cial in the insurance industry, where managing potential
is vast and untapped. With a sophisticated AI system, insur- losses can make or break a business. Having the right tools
ance companies can quickly and precisely identify and address in place to streamline investigations is key to quickly spot-
fraudulent activities, thereby reducing the time, resources, and ting and responding to fraudulent proposals and claims while
financial burdens associated with combating fraud. ensuring legitimate ones are processed without delay.

This is where fraud control systems like the Kriyam.ai Inves- An AI-powered investigation platform like Kriyam.ai is the
tigation Platform come in. By tapping into the power of ar- key to combating fraud and saving crores in losses. With
tificial intelligence and integrating smart automations into Kriyam.ai, insurance investigations become faster, more
the workflow, it doesn't just streamline operations-it super- accurate, and fully secure-helping insurers reduce risk, im-
charges them. prove profitability, and maintain a competitive edge.

Here's how Kriyam.ai is revolutionizing the inves- Reference
1 https://timesofindia.indiatimes.com/city/mangaluru/
tigation process:
about-15-of-insurance-claims-in-india-are-fraudulent-
i. Paperless Operations: Digitizes every step of the in- says-expert/articleshow/108280703.cms
vestigation process through web and mobile apps, elimi- 2 https://www2.deloitte.com/content/dam/Deloitte/in/
nating physical document handling and minimizing er- Documents/financial-services/in-insurance-fraud-sur-
rors. vey-2023-noexp.pdf
3 https://groww.in/blog/insurance-frauds-in-india
ii. Centralized Case Monitoring: Offers all case data con- 4 https://indiaforensic.com/india-loses-6-25-billion-to-
solidated into a single pane of view with AI-enabled insurance-frauds-an-indiaforensic-research/
insights and anomaly detection, enabling insurers to ?srsltid=AfmBOor1qMLjUZPfKriYv_JYvFoIJOQq-
monitor investigations effectively. XM6fXahL49oOueBaZ0K4A22
5 https://www.business-standard.com/finance/insur-
iii. AI powered Workflows: Utilizes artificial intelligence ance/irdai-annual-report-2023-24-insurance-penetra-
and rule-based automations for assigning cases to in- tion-decline-124122500470_1.html

The Insurance Times March 2025 27