The insurance company AXA has announced an ambitious plan to expand the use of artificial intelligence in claims management, aiming to improve fraud detection and ensure the authenticity of submitted documents. Currently, the company processes between 25,000 and 30,000 documents related to claims each day, of which only 500 are analyzed using AI technology. However, by the end of 2025, it is expected that this number will increase to 6,000 daily documents, always in compliance with current regulations. These data come from the XII AXA Fraud Map in Spain, a comprehensive study on this phenomenon in the insurance sector.
The implementation of artificial intelligence has allowed AXA to more effectively manage the vast amount of data available in the sector. This technological advance has been crucial in reducing the number of investigated suspicious cases, which decreased from over 74,000 in 2021 to less than 64,000 in 2024. However, detected fraud cases have remained stable, between 23,000 and 24,000 annually in the last five years. Arturo López-Linares, Claims Director of AXA Spain, emphasizes that in 2013, only 3% of fraud cases were detected through digital means, thus avoiding undue payments totaling two million euros. In contrast, in 2024, this percentage was 30%, preventing fraudulent compensations totaling 26 million euros.
The insurance fraud rate in Spain has shown a slight increase, reaching 1.97%, which is an increase of four tenths compared to the previous year. This increase is partly due to the improvement in detecting fraudulent cases, which have grown from 15,000 in 2012 to over 23,000 in 2024. AXA has managed to prevent fraudulent payments totaling around 87 million euros in 2024, surpassing the 84 million avoided in 2023. This trend in increased fraud detection has allowed for honest customers’ premiums to be reduced, generating significant savings in insurance such as Liability (44%) and Fire (23%).
Regarding the distribution of fraud by types of insurance, the Auto sector continues to be the most affected, representing 56% of cases in 2024, although it has had fluctuations in recent years due to reforms in the Claims Assessment Scale. The Multirisk branch, which includes Home, Commerce and Offices, and Communities, has seen its percentage of fraud decrease from 40% in 2020 to 28% in 2024. In contrast, the Miscellaneous branch has increased from 7% in 2012 to 15.7% in 2024.
As for the characteristics of fraud, nearly 60% corresponds to real claims in which unrelated damages are attempted to be included, while 39% are premeditated. Organized schemes represent a smaller percentage but usually involve higher amounts defrauded.
Geographically, the regions with the highest fraud rates in 2024 were Melilla, Navarra, and Andalucía, while Castilla-La Mancha, Basque Country, Madrid, Catalonia, and Ceuta recorded the lowest figures. In terms of gender, no significant differences are observed at the national level in the Auto branch, although variations are seen at the provincial level. For example, in Guadalajara, men are responsible for 88.6% of fraud cases, while in Ceuta, Melilla, Huesca, and Orense, women commit fraud more frequently than men in relative terms. In the Home branch, significant gender differences are also recorded by province, such as in Palencia, where men commit 69% of fraud despite representing 59% of Home insurance.
In summary, AXA’s investment in technology has facilitated a more effective fight against fraud, protecting the interests of honest customers and reducing the costs associated with fraudulent compensations.
Source: MiMub in Spanish
