Why judgement matters in fraud detection for vulnerable customers

Insurance fraudsters are increasingly using AI to their advantage.??

AI deepfakes and shallowfake document edits show just how easy it is to create convincing false claims.?

To fight rising insurance fraud, we've enhanced our use of the industry's top AI software. We seek out shallowfakes and tackle fraud with amazing speed and accuracy.???

However, artificial intelligence is not human intelligence. AI has no responsibility to the individual; it applies no context and it feels no empathy. We provide services for one of the largest vulnerable groups in our industry. Context, understanding and empathy are essential to our clients.??

Discover how we help some of our industry’s most vulnerable people.??

Helping vulnerable people??

We work closely with a large UK insurer who provide vulnerable customers with an opportunity to get motor vehicles. They are the single biggest vulnerable customer base in the industry. We have worked with them on special investigations for almost 28 years.??

That vulnerable customer base includes people with a wide range of both physical and cognitive disabilities.??

The scheme is a wonderful example of how we can level the playing field for all. Sadly, it’s the way of the world that people are out to take advantage of schemes like this and the vulnerable people they serve.??

That’s where we can help.?

Tact, not trauma??

Managing cases involving vulnerable people needs sensitivity. People shouldn’t feel accused when they haven’t done anything wrong. We need to avoid adding any stress or anxiety they might already have. At the same time, it’s our job to make sure vulnerabilities aren’t used for unethical or illegal purposes.?

Exploiting vulnerability – an example?

A lady might be a wheelchair user due to respiratory issues. She relies on her vehicle to get around. However, an insurance claim is submitted by a named driver—their son—who may be using the vehicle improperly or allowing others to use it who aren’t insured.??

Our role involves visiting her home, assessing what’s happened with care and ensuring she understands the reality of the situation. She might think her son can do no wrong, but we’re tasked with revealing the truth, even if it’s hard to hear.?

Responsibility to the individual??

Insurance investigations can be a prickly subject. People might think they're only there to catch people out and save insurers money. While our job is to use our industry expertise to get to the truth, we apply human and emotional intelligence to each case.??

• Many of our investigators are former police or military personnel. They have experience and training in dealing with vulnerable people and easing challenging situations.?
• We use local field investigators with a familiar voice—people who can identify with the customer and build rapport. Hearing a local accent from someone who knows the area can add a level of calm to what might be a stressful or awkward situation. ??
• Sometimes customers need medication that affects their cognitive or physical ability. It can also impair an investigation’s accuracy.?We take the timing of any medication needs into account so we can carry out investigations effectively without disturbance to the client.???
• Our agents have gone beyond their duties, even shopping for vulnerable clients to ensure they’re cared for.?

For us, it’s not just about the outcome of an investigation. Our skilled team and cutting-edge AI handle that. It’s about caring for the people who need it most, with compassion and understanding.?

Keeping people safe?

For almost 30 years we’ve been a safe pair of hands for our clients, managing difficult situations involving vulnerable people with skill and empathy.??

Using the latest AI software in Lynx document validation, combined with years of knowledge, experience and true human intelligence, we’re leading the charge against digital insurance fraud.??

Understand how we can protect your business and clients. Let’s talk.??