Czech insurance companies uncover fraud using AI, facing up to ten years in prison
Czech insurance companies are deploying artificial intelligence systems to detect insurance fraud. Perpetrators face hefty fines or imprisonment of up to ten years.
AI in insurance companies detects even hundred-crown fraud, motorists at greatest risk
Czech insurance companies are progressively implementing artificial intelligence systems capable of detecting discrepancies even in cases worth only hundreds of crowns, according to Deník.cz. Experts warn that attempted fraud can result in legal proceedings or imprisonment.
The systems analyse approximately 1.1 million documents annually. From this volume, they detect several thousand instances of altered data, with the value protected reaching units of millions of crowns. Most frequently, this involves amendments to health documentation and invoices.
"AI tools increase the speed and accuracy of document verification. Resistant AI's document forensic analysis tracks, recognises and reports discrepancies in documents submitted for insurance claim settlement. The highest-risk cases are subsequently inspected by claims adjusters and, if necessary, further handled with the internal security team," explained Ondřej Poul, director of the Insurance Claims Settlement Centre at Kooperativa.
Dita Němečková, head of the Investigation and Prevention Department at Kooperativa insurance company, clarified that clients often risk serious complications because of trivial fraud. "What often surprises us is that clients risk serious complications even for minor matters, fraud of a few hundred crowns," said Němečková.
AI prevents sophisticated forgeries created using artificial intelligence
Insurance companies also face a new phenomenon: fraudulent materials altered directly using AI tools. "AI significantly increases the quality of fraudulent materials and places new demands on our detection systems and specialists," said Karel Polák, director of the security and insurance fraud division at UNIQA.
UNIQA insurance company specialists prevented unauthorised payments exceeding 81 million crowns last year. The number of fraud attempts declined, however the average amount protected per case increased. Similar developments continued in the first quarter of this year. The largest savings were recorded in compulsory liability insurance, followed by comprehensive and property insurance.
Criminal offence with threat of ten-year imprisonment
The Czech Insurance Association recalls that insurance fraud is classified as a criminal offence, for which perpetrators face up to ten years in prison. Experts define who commits fraud: "Anyone commits insurance fraud who provides false or grossly distorted information, or deliberately withholds certain information." It is also considered fraud when someone deliberately causes or simulates an insured event with the aim of unlawful enrichment.
Specialists therefore recommend motorists and other policyholders not to attempt even seemingly negligible fraud. An attempt to gain several hundred crowns can result in substantial fines and legal proceedings.
Source: Deník.cz