Kyobo Life Develops Insurance Fraud Prediction System Incorporating AI Machine Learning

Kyobo Life Insurance announced on the 26th that it has developed an insurance fraud prediction system (K-FDS) incorporating artificial intelligence (AI) machine learning technology.

[Asia Economy Reporter Oh Hyung-gil] Kyobo Life Insurance announced on the 26th that it has developed an insurance fraud prediction system (K-FDS) incorporating artificial intelligence (AI) machine learning technology.

The AI autonomously selects and learns the characteristics of insurance fraud and identifies targets exhibiting similar behaviors, enabling immediate response to rapidly evolving insurance fraud methods. Early detection of suspected insurance fraud cases among insurance claims significantly improves proactive response support functions compared to the previous method, which relied solely on the intuition or experience of insurance fraud investigators.

While existing AI insurance fraud detection systems in insurance companies focus on exemption during insurance claim reviews, K-FDS is characterized by its focus on early warning and proactive response to purely suspected insurance fraud types and cases.

Data such as insurance contracts and accident information are automatically grouped by frequently occurring diseases and injury groups suspected of insurance fraud through the latest machine learning techniques and robotic process automation (RPA). To counter organized insurance fraud, it automatically identifies suspected conspirators and supports analysis of connections with the relevant hospitals and insurance agents.

Since July 2018, Kyobo Life Insurance has prevented improper insurance payments by identifying over 200 suspected insurance fraud cases through pilot operations.

A Kyobo Life Insurance official stated, "This is an example of implementing ambidextrous talent who thoroughly understand both the essence of life insurance and digital technology," adding, "Through timely insurance fraud prediction and proactive response, we will contribute to establishing a sound insurance culture and protecting consumers."

This content was produced with the assistance of AI translation services.