He shed light on the role of AI and automation in fraud detection and claims processing within the insurance industry. He highlighted that 8-10% of claims globally are fraudulent, yet the industry detects only a fraction of them.
Rahul also highlighted how Medi Assist is leveraging AI-powered fraud detection, and has achieved 2.5-3% fraud detection—significantly higher than the industry standard. By using AI-driven adjudication engines, they provide real-time claim deductions with justifications, allowing customers to dispute or accept decisions. This customer feedback loop helps refine processes, leading to more accurate and fair claim settlements while ensuring insurers can better underwrite policies and reduce premiums.
