Unmasking Fraudulent Insurance Claims with Facial Recognition

THE CHALLENGE

  • A South African insurer was faced with a potentially fraudulent $250 000 HIV insurance claim
  • The insurance Ombudsman required definitive proof of the fraud before they would allow the repudiation of the claim to stand

TECHNOLOGY USED

THE SOLUTION

visionAI’s facial recognition and ID verification solution was used by the insurer to objectively and scientifically compare the identification images of the claimant.

The solution analyzed facial features in the images and provided a result with a low confidence that the images were of the same person who obtained a negative HIV test.

BUSINESS OBJECTIVE

The main objective in this case was fraud reduction. The insurer aimed to prevent fraudulent claims and mitigate financial loss by using visionAI’s facial recognition solution to provide scientific evidence and support their decision in rejecting a fraudulent HIV insurance claim.

THE RESULT

The insurer successfully defended their decision to reject the fraudulent claim, as supported by the scientific evidence provided and the Ombudsman rejected the claimant’s appeal.

The insurer saved $250,000 and showcased the effectiveness of visionAI’s facial recognition technology in fraud reduction for the insurance industry.

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