Causes and Effects and Prevention of Insurance Fraud -A Systematic Literature Review


Syamkumar K, Dr (Prof) J.Sridevi,  Ninu Ashraff ,  Kavitha K.S 

 DOI10.5110/77. 1610              Page:   106-122         Vol: 19    Issue: 06   Year: 2024

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The insurance industry has always been crucial to the economy and society’s progress worldwide. In reality, insurance confronts many risks, one of which is Insurance fraud. Insurance fraud is increasing rapidly along with the growth of the insurance sector, which causes serious social and economic issues. The damage caused by insurance fraud has been continuously increasing, making the insurance companies harder to manage. As a result, the insurance premiums have risen, which in turn causes losses to good policyholders. As the world is at the pace of rapid innovation with the emergence of the industry revolution 4.0, the Insurance sector is adopting advanced technology, making many positive changes in the insurance industry with the introduction of Artificial Intelligence. In this study, the authors focus on Systematic Literature (SLR) confined to the reasons insurance fraud happened in various segments, the parties involved in it, its consequences, and also to take preventive measures by adopting AI technology to reduce insurance fraud. The paper focuses on creating an outlook of Insurance fraud from a holistic perspective by interconnecting the issues relating to various insurance areas and finding solutions to mitigate insurance fraud. The findings of this paper make academics conscious of the significant role of technology, including AI and ML modes, in detecting and preventing insurance fraud. 


Insurance, Insurance fraud, Fraud detection, Information Technology, Artificial Intelligence

Received:  25 March 2024

Accepted:   18 May 2024

Published:  29 June 2024