The Canadian Life and Health Insurance Association (CLHIA) has announced the expansion of its AI-driven programme to pool claims data, enhancing fraud detection capabilities.
This initiative, which leverages AI, aims to strengthen the financial stability of the insurance sector and ensure the sustainability of group benefits plans.
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The initiative builds on a programme launched in 2021, which provided Canada’s life and health insurers with analysis derived from Shift Technology’s fraud detection solutions. CLHIA’s board has now approved expanding the programme to include more providers and data.
CLHIA CEO and president Stephen Frank said: “Improved fraud detection benefits all Canadians.
“By strengthening the financial stability of the insurance industry, insurers can protect the affordability and accessibility of vital group benefits programmes.”
Each Canadian insurer employs its own analytics to detect suspicious claims. However, CLHIA’s collaboration with Shift Technology extends these efforts by using AI to analyse industry-wide de-identified claims data. This approach helps insurers identify patterns and connect data across a vast pool of claims over time.
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By GlobalDataShift Technology co-founder and CEO Jeremy Jawish said: “Using artificial intelligence to identify potential fraud has proven incredibly beneficial for individual insurers.
“The work we are doing with the CLHIA builds on those individual efforts to provide a more comprehensive, industry-wide perspective on suspicious behaviour, benefitting all member organisations in their fight against fraud.”
In 2023, insurers paid $36.6bn (C$50.38bn) in supplementary health claims, with fraud activities costing millions annually.
CLHIA’s members account for 99% of Canada’s life and health insurance business. These insurers provide financial security products to nearly 30 million Canadians, hold more than $1tn in assets and employ almost 180,000 Canadians.
Shift Technology partners with insurance companies to reduce fraud and risk, streamline claims processes and enhance customer experiences through AI.
Last year, the Canadian Automobile Association (CAA), a federation of eight regional not-for-profit automobile associations in the country, signed a strategic partnership with insurance company Securian Canada.
Via this partnership, the CAA launched a range of insurance offerings for more than seven million of its members.
