Insurance fraud fighters face dual AI challenge as criminals match their tactics
Insurance counter fraud teams are caught between two competing pressures: deploying AI to speed up claims processing while fraudsters use the same technology to automate and intensify attacks.
Experts gathered at an Insurance Times Fraud Charter roundtable on 18 March 2026 described an industry at a crossroads. Insurers want faster claim assessment and straight-through processing. Criminals are using AI for reconnaissance, target identification, and research to hit insurers harder.
Matt Gilham, director at Whitelk Fraud Performance Consulting, said: "Fraudsters are using AI in the same way that we are looking to use it within our organisations. The world of AI fraud is moving very quickly and is going to be a challenge for us."
Speed versus control
The core tension is unavoidable. Slowing down claims processing to catch more fraud frustrates customers and damages competitive advantage. But investing heavily in counter fraud capabilities is expensive.
Gilham added: "As we try to move faster, we have to reckon with the further weaponisation of AI by bad actors - meaning there's this tension between speed and operational expenditure, indemnity control and fraud vulnerabilities."
Fraud Charter attendees agreed that waiting passively for attacks was not an option. The insurance sector needs to invest in counter fraud capabilities now or face worse outcomes later.
Tools that work both ways
Some technology solutions allow insurers to maintain speed without sacrificing fraud detection. Laura Horrocks, customer success manager at fraud technology supplier Shift Technology, said combining multiple data sources improves detection accuracy.
"If you can get an IP address from the customer's device they use to present the claim, then that's gold dust," Horrocks said. "You can then match that to other claims and check for repeated activity."
Simon Mattless, claims counter fraud lead at Aviva, said: "AI will allow us to move to a space where we use the broadest width of scoring to automate validation steps, meaning the customer can keep progressing and we can keep the customer journey flowing fast while being safe."
Extending fraud team capacity
AI also helps fraud investigators handle more cases. Most fraud teams prioritise high-value cases and skip lower-priority ones simply due to resource constraints.
Victoria Wallace, head of fraud at Zego, said: "If we use AI and think about agents that can help us automate fraud investigations while making them faster, we can definitely do more. There's definitely ways that we can use AI to be better at pretty much everything."
Automating investigation workflows frees staff to focus on complex cases that require human judgment.
For those working in insurance, understanding both the defensive and offensive applications of AI in fraud has become essential. AI for Insurance and Generative AI and LLM resources can help professionals stay current with how the technology is being deployed across the sector.
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