On December 1, AIA Life Insurance announced that it has further strengthened consumer protection in the insurance payout process by advancing its proprietary large language model (LLM)-based artificial intelligence (AI) optical character recognition (OCR) technology, which has achieved results in detecting suspected insurance fraud cases.
In August, AIA Life Insurance introduced an LLM-based AI OCR solution to its insurance claim service. For small claims such as hospitalization, surgery, or fractures, the system automatically recognizes and inputs key information required for claims simply by photographing hospital documents. This system not only accurately recognizes even unstructured documents, significantly speeding up the insurance payout process, but has also recently been expanded to the area of insurance fraud detection.
The case recently detected by AIA Life Insurance began when the AI system automatically identified abnormal patterns in some claim diagnosis certificates submitted to the company, which differed from standard formats. AIA Life Insurance applies a method that automatically extracts and verifies diagnosis-related information from certificates using the LLM-based AI OCR solution. During this process, the system simultaneously checks for consistency in diagnosis information on claim documents, verifies the authenticity of submitted documents, and analyzes fraudulent claim patterns.
Upon detecting these anomalies, AIA Life Insurance conducted an internal review to thoroughly examine the facts and shared suspicious circumstances of fraudulent claims with investigative authorities. Subsequently, an investigation by the police station in Masan confirmed that an insurance planner had attempted fraud by misusing another person's medical records under family member names to make fraudulent claims with multiple insurers. Through the provision of relevant materials and cooperation in the investigation, AIA Life Insurance participated in the case, helping to prevent fraudulent payouts in advance and contributing to the protection of customers' valuable assets.
AIA Life Insurance explained that this case demonstrates how AI-based OCR technology can play a substantial role in protecting customer rights and interests-not only by automating document entry work, but also by enabling early detection of document forgery, falsification, and abnormal claim patterns that may be difficult to catch through manual review alone, thereby preventing insurance fraud.
Oh Sungjun, Head of Customer Operations at AIA Life Insurance, stated, "The insurance claim and payout process is the point where customers and insurers interact most closely, and where the consumer protection emphasized by financial authorities is truly realized. By leveraging the LLM-based AI OCR solution, we will strive to expedite legitimate claim payments and proactively block insurance fraud, ensuring even greater protection of our customers' assets."
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