Canada’s Life and Health Insurers Use Advanced AI to Combat Fraud
The Canadian Life and Health Insurance Association (CLHIA) is stepping up its fight against insurance fraud by expanding a data pooling program enhanced with artificial intelligence (AI). This move aims to speed up fraud detection and protect the financial health of group benefits plans across Canada.
"Improved fraud detection benefits all Canadians," said Stephen Frank, President and CEO of the CLHIA. "By strengthening the financial stability of the insurance industry, insurers can protect the affordability and accessibility of vital group benefits programs."
From Data Pooling to Industry-Wide AI Analysis
The initiative builds on a 2021 program where Canadian insurers began sharing claims data to leverage AI-powered insights provided by Shift Technology. Now, the CLHIA board has approved expanding this program to include more providers and a larger volume of data. This expansion reflects a clear commitment to safeguarding the integrity of the insurance system.
Each insurer typically conducts its own internal analytics to flag suspicious claims within its portfolio. The partnership with Shift Technology adds an industry-wide layer of protection. AI-driven alerts based on deidentified claims data help insurers detect patterns and connections that individual data sets might miss.
How AI Enhances Fraud Detection
Jeremy Jawish, CEO and co-founder of Shift Technology, explains, "Using artificial intelligence to identify potential fraud has proven incredibly beneficial for individual insurers. Our work with the CLHIA broadens that benefit by providing a more comprehensive, industry-wide perspective on suspicious behavior."
In 2023, Canadian insurers paid out $36.6 billion in supplementary health claims. Fraud is estimated to cost millions annually, undermining the sustainability of benefits programs. Expanding the AI-powered detection program is a strategic response to this challenge.
About the Canadian Life and Health Insurance Association (CLHIA)
- Represents companies covering 99% of Canada's life and health insurance market
- Provides life insurance, annuities (including TFSAs, RRSPs, RRIFs, and pensions), and supplementary health insurance
- Serves nearly 30 million Canadians
- Manages over $1 trillion in assets and employs almost 180,000 people across Canada
About Shift Technology
Shift Technology is a trusted AI partner for leading insurers worldwide. Their AI solutions help reduce fraud, manage risk, streamline claims processing, and improve customer experience. Combining industry expertise with advanced technology, Shift delivers measurable business impact and return on investment.
Learn more about Shift Technology at www.shift-technology.com.
Your membership also unlocks:
