The Canadian Life and Health Insurance Association (CLHIA) is expanding its data pooling program that uses artificial intelligence to detect potential fraud more efficiently.
The initiative, first introduced in 2021, allows life and health insurers in Canada to access shared fraud-detection tools.
The expansion includes additional providers and more data, aiming to support the financial stability of group benefits plans.
According to the CLHIA, AI-driven analysis of deidentified claims data helps insurers detect suspicious patterns across a large volume of transactions.
While each insurer maintains its own fraud analytics, the shared system supplements individual efforts and improves industrywide oversight.
The association partners with Shift Technology to support this framework.
CLHIA President and CEO Stephen Frank said enhanced detection strengthens the insurance industry’s financial footing, which helps maintain affordability and access to group benefits for Canadians.
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 programs.
Stephen Frank, president and chief executive officer of the CLHIA
Canadian insurers paid $36.6 bn in supplementary health claims. The industry estimates fraud costs amount to millions annually.
The announcement follows broader attention to fraud prevention, including a recent move in the U.S. where North Dakota merged its Department of Securities into the Department of Insurance to bolster enforcement.
